• Supervises and coordinates the daily operations of the PB Insurance Credits team • Monitors corrections related to discrepancies • Reviews and tracks data regarding credit resolution activities • Engages in continuous quality improvement initiatives • Evaluates potential new colleagues and makes hiring recommendations

Role Description The Access Coordinator gathers necessary insurance information and uses expertise to translate the information provided by the patient/guarantor into the computer system, resulting in accurate claim submissions. - Prepares and submits payer-specific prior authorizations and referrals in alignment with relevant guidelines and medical policy criteria. - Accurately identifies required insurance verification and medical documentation in accordance with payer policy. - Collaborates with clinicians and medical practitioners to obtain all necessary information for successful authorization approval. - Thoroughly documents all interactions and actions related to insurance processes within the electronic Medical Record (EMR) system. - Regularly reviews and monitors assigned work queues, identifying and focusing on accounts with the highest financial reimbursement risk. - Adapts to urgent clinical needs while maintaining high-quality work outputs within specified timelines. - Communicates with patients as needed to facilitate medical clearance. - Develops pre-service estimates and supports pre-service collections. - Supports the review of prior authorization requests that do not initially meet criteria and works collaboratively with relevant stakeholders to resolve issues or coordinate necessary clinician-to-health plan interventions. Qualifications - 1 year of relatable healthcare experience. Requirements - Healthcare experience within patient care, registration, scheduling, pre-certifications/prior authorizations, collections, and medical terminology. Benefits - Comprehensive medical, dental, vision, life, and disability insurance. - Supplemental options to fit your needs. - 401(k) plan with employer contributions. - Professional development through training, tuition reimbursement, and educational programs. - Flexible scheduling and generous time off. - Wellness resources focused on physical, mental, and emotional health.

Role Description Under limited supervision the Insurance Authorization Specialist reviews and manages the benefits and authorizations for hospitals and physicians. This type of specialist acts as an intermediary between the medical institution, patients, and the insurance agency. They assist in verifying benefits and obtaining authorizations for inpatient and outpatient services. - Maintain work queue assigned by the client - Verify benefits and secure authorization for inpatient and outpatient services - Perform other duties as directed - Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance Qualifications - Knowledge of medical and insurance terminology such as CPT, ICD-9, ICD-10, HCPCS, co-pay, deductible or co-insurance - Minimum 1-2 years’ experience in Medical Billing/Coding - Experience with standard office software products - High School diploma or equivalent Requirements - Ability to prioritize and multi-task in a fast-paced, changing environment - Demonstrate ability to work in all work types and specialties - Demonstrate ability to self-motivate, set goals, and meet deadlines - Demonstrate leadership, mentoring, and interpersonal skills - Demonstrate excellent presentation, verbal, and written communication skills - Ability to develop and maintain relationships with key business partners by building personal credibility and trust - Maintain courteous and professional working relationships with employees at all levels of the organization - Work in accordance with corporate and organizational security policies and procedures - Demonstrate excellent analytical, critical thinking and problem-solving skills - Manage the Individual KRA’s as per the provided metrics - Understand client requirements and specifications of the project and ensure targeted collections are met on a daily/monthly basis - Meet the productivity targets of clients within the stipulated time - Ensure timely follow-up on pending claims and prepare and maintain individual status reports - Skill in operating a personal computer and utilizing a variety of software applications is essential - Knowledge of coding convention and rules established by AHIMA, AMA, AHA, and CMS is an added advantage - Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records is an added advantage Benefits - Comprehensive benefits package including health, dental, and vision coverage - Voluntary insurance options - 401(k) plan with employer match - Professional development opportunities - Paid time off and holiday pay - Opportunity to participate in bonus programs, commissions, or other variable incentive plans Company Description Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines.

Role Description RAYUS Radiology is looking for an Insurance Specialist to join our team. As an Insurance Specialist, you will be responsible for providing expertise in insurance pre-certification and authorization of services by calling insurance companies and patients to verify insurance information. You will develop and maintain positive relationships with referring physicians and patients. This is a remote, temporary (PRN) position, working Monday-Friday as needed (about 30 hours per week). Essential Duties and Responsibilities: - (65%) Insurance Administration - Prioritize workload to ensure all patients are contacted prior to their exam and those with largest responsibility to pay are given highest priority. - Determine if patient's insurance is a part of the provider network. - Make outgoing calls to insurance companies for pre-certification or any authorization. - Receive pre-authorization from patients and/or insurance companies and document. - Contact patient and referring offices using HIPAA guidelines prior to scheduled exam when additional insurance information is needed. - Accurately enter a variety of information including date schedule requests received, patient name, referring physician and procedures into computer system. - Maintain positive interactions with referring offices, patients and staff. - Backup front desk reception and scheduling area as needed. - (30%) Price Quotes - Complete payor-related information, i.e., payor, payor class, date of appointment. - Obtain all workers compensation approvals from insurance companies prior to scheduled exam. - Obtain patient signs and symptoms in order to support medical necessity. - (5%) Completes Other Duties and Projects as Assigned Qualifications - High School Diploma, or equivalent. - One (1) year of healthcare experience working with a variety of health insurance plans for pre-certification and authorization of benefit coverage. - Prior experience with managed care and physician office scheduling. - Microsoft Office Suite Experience. - Proficient with using computer systems and typing. - Bilingual (preferred). Benefits - Medical, dental and vision insurance. - 401k with company match. - Life and disability insurance. - Tuition reimbursement. - Adoption assistance. - Pet insurance. - PTO and holiday pay. - Many more benefits (based on eligibility). Company Description RAYUS is committed to delivering clinical excellence in communities across the U.S., driven by our passion for and superior service to referring providers and patients. RAYUS Radiology is built on our brilliant medicine, brilliant team, brilliant technology and services - all to provide the highest level of patient care possible. We bring brilliance to health and wellness. Join our team and shine the light on Radiology Services! RAYUS Radiology is an EO Employer/Vets/Disabled.