Lead Insurance Services Rep

The Lead Insurance Services Specialist (ISS) oversees the daily operations of the Insurance Services team, ensuring claims submission and collections are completed in a timely manner, service level agreements (SLAs) and key performance indicators (KPIs) are met, and acting as a liaison between the Insurance Services team and key stakeholders. They provide training for new Insurance Services Specialists (ISS)), support new program implementation, and assist with appeals, denial trend reviews, This role requires a proactive, team-oriented leader who thrives in a fast-paced environment and is committed to ensuring the success of the Insurance Services team.

• Support Insurance Services Supervisor with providing oversight for the Insurance Services department.
• Support Insurance Services Supervisor with hosting and participating in regular billing meetings and provide feedback for problem solving with insurance billing and A/R issues.
• Serve as the primary mentor for new hires and support the onboarding process to ensure new hires are able to work independently upon completion of training.
• Take on, or lend assistance with, special projects related to Insurance Services and the RCM team.
• Actively participate in workloads to remain a subject matter expert in all things related to the department.
• Ensures the validity and integrity of all patient insurance records.
• Responsible for timely responses to insurance rejections and denials, monitoring for trends, and providing feedback on operational processes.
• Responsible for working aging report while maintaining account status records and collection efforts in centralized note system.  This includes making recommendations on adjustments, refunds, and outside collection activity in alignment with company policy and procedures.
• Engage in cash application process, making sure all cash receipts are applied accurately and timely
• Provide feedback to program on how to ensure compliance while maximizing revenue.
• Responsible for timely response on requests for refunds as received from insurance company; requests will be validated for accuracy and challenged when not accurate.  This includes monitoring assigned accounts to identify overdue payments and issue refunds on overpayments.

• Commercial Insurance Billing Experience
• Stakeholder Relationship Building
• Technology and Systems Knowledge
• Experience in Behavioral Health or Medical Healthcare Settings
• Excellent Communication and Presentation Skills