Lead, Insurance Claims Processing
US-TX-Irving
External Careers apply (Attract Portal)
Req #: 104611
Type: Full-time
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Overview: The primary purpose and function of a Lead, Insurance Collections Specialist is to be responsible for assisting ROC Billing Supervisors by providing support with daily tasks and working collectively as a team with ROC team members. Responsibilities * Will be responsible for training and complying with all duties assigned to the ROC Insurance Collection Specialist. * Lead team to maximize office collections, communicate issues, and implement ideas to improve processes. * Maintain and ensure that insurance carrier standards are up to date. * Share updated information from insurance carriers in the form of quick reference guides. * Assist ROC Billing Operation Supervisors in the development and training of team members. * Provide end of day/week reports to ROC Billing Operation Supervisors on team progress. * Lead daily office hours with the onshore team to support the development and training of team members. * Provide staff with assistance in performing difficult or complicated accounts. * Collaborate and share feedback with ROC Billing Operation Supervisors to increase team efficiency and communication. * Work with cross functional departments to research & resolve issues using innovative solutions. * Be able to complete assigned tasks and other duties assigned from ROC Billing Operation Supervisors. * Lead and participate in meetings and training sessions as required. * Provide auditors, billers, insurance collection specialists with assistance in the follow-up outstanding questions. * Ensures training and compliance modules are completed as needed for all new team members. * May be involved in assisting with work distribution for onshore and offshore team members. * Interact with other PDS departments and team members regarding certain operations. This includes but is not limited to plan credentialing, eligibility, fees, pre-authorizations, billing, auditing, claims follow-up, LT&D, Epic, IT, and Regional Analysts. * Maintains an appropriate professional appearance and demeanor in accordance with Company standards. * Other duties as assigned. Qualifications * 0-1+ years of professional experience * Equivalent to high school diploma or general education degree (GED) * EPIC knowledge * Ability to interpret EOB (Explanation of Benefits) Preferred * Associate or Bachelor's Degree or a one-year certificate from an accredited college or technical school; or equivalent combination of education and experience * Minimum of 6-month experience in medical or dental setting Knowledge/Skills/Abilities * Ability to multi-task effectively without compromising the quality of the work. * Excellent interpersonal, oral, and written communication skills. * Detail oriented, organized, process focused, problem solver, proactive, ambitious, customer service focused. * Ability to draw conclusions and make independent decisions with limited information. * Ability to respond to common inquiries from customers, staff, regulatory agencies, vendors, and other members of the business community. * Self-motivated, reliable individual capable of working independently as well as part of a team. * Problem solving skills to gather & analyze information to identify and resolve problems in a timely manner. * Analytical skills to synthesize complex or diverse information. * Ability to research information and analyze data to arrive at valid conclusions, recommendations, and plans of action. * Actively share ideas in a constructive and positive manner by listening to and objectively considering ideas and suggestions from others. Benefits * Medical, dental, and vision insurance * Paid time off * Tuition Reimbursement * 401K * Paid time to volunteer in your local community Responsibilities: PDS Health is an Equal Opportunity Employer. We celebrate diversity and are united in our mission to create healthier and happier team members.
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