The Virginia Eye Institute is hiring! VEI is a large and dynamic multi-specialty practice of ophthalmologists and optometrists in the Richmond, VA area, including eight locations and an ambulatory surgery center. We are searching for a Case Management Specialist Lead (CMS Lead) to join our Revenue Cycle department. We are looking for dependable candidates with outstanding mindfulness skills and excellent customer service. The ideal candidate will be a team-player, initiative-taker, friendly, motivated, organized, and can work independently while sustaining a team environment. A caring demeanor and the ability to build and support patient rapport is critical. The candidate must show leadership skills, be highly productive, eager to learn, and motivated to succeed. The Case Management Specialist Lead helps oversee workflows and processes required for obtaining the necessary insurance authorizations for patients requiring treatment or surgery. Our CMS Lead will also coordinate with the case management team and liaise with management to help optimize current prior authorization processes. RESPONSIBILITIES:Lead the case management team in adhering to workflows and authorization processes ensuring timely authorization approvals and effective handling of authorization denials.Help management in Implementing strategies for patient financial assistance and copay programs, ensuring comprehensive patient support. Foster effective communication within the team and with external stakeholders to maintain lofty standards of patient care. Function as a pivotal resource in understanding and navigating complex insurance and payer specific prior authorization requirements.Help management with achieving measurable improvements in medical authorizations process and patient financial assistance programs. Enhance patient satisfaction by reducing wait times for authorization approvals and increasing access to necessary medical treatments.Help in developing a well-informed and agile team capable of responding to changing healthcare regulations and insurance policies. Help in maintaining team knowledge on the top office and outpatient surgical procedures that require prior authorizations.Help in maintaining team knowledge on copay assistance programs, communicate with patient as needed within timely turnover prior to procedure.Help in maintaining team knowledge on current processes to obtain authorizations (buy and bill, specialty pharmacy, step therapy, benefit investigations, financial assistance). REQUIREMENTS:Minimum education: HS diploma or equivalent, associate degree or some college education preferred.Thorough understanding of Insurance eligibility ICD-10, HCPCS and CPT knowledgeWindows-based software applications (i.e., Word, Excel)Knowledge of medical terminologyStrong interpersonal communication skills, including the ability to set up and support effective relationships with payers, physicians, management, and co-workers.Demonstrates mindfulness.Maintains cheerful outlook and friendly demeanor with other team members. We are an equal opportunity employer.