Insurance Specialist
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Job Location:
Monthly Salary:
Posted on:
13 hours ago
Vacancies:
1 Vacancy
Job Summary
Lourdes Hospital
Job Title: Insurance Specialist
Job Type: Full time Monday - Friday
Wage Range: $
POSITION SUMMARY
The Insurance Specialist is responsible for the verification/documentation of insurance benefits securing pre-certification/referral numbers and estimating/collecting patient liabilities on all outpatient scheduled procedures.
Reports to: Patient Access Supervisor. FSLA: Non-exempt
ESSENTIAL FUNCTIONS
To perform this job an individual must perform each essential function satisfactorily with or without a reasonable accommodation.
- Ensures that pre-certifications required by managed care companies for scheduled surgeries and procedures are obtained on a timely basis and documented in advance of appointment
- Notifies physician offices and centralized scheduling in the event pre-cert is not obtained in time for patient appointment
- Heavy phone and payer website contact in accordance with payer pre-cert and verification regulations
- Communicates with insurance payers regarding any CPT code discrepancies or changes made due to radiologist discretion
- Performs insurance verification eligibility and pre-certification for outpatient scheduled procedures.
- Maintains current knowledge of outpatient imaging policies and procedures
- Verifies the patient has active insurance coverage and obtains insurance benefits utilizing insurance eligibility tools payer websites and payer phone systems
- Communicates with Benefits and Notification Specialist whenever a patient has no verifiable insurance benefits to cover a scheduled procedure
- Works closely with physician offices and departments of the hospital when obtaining clinical information providing them with necessary information or forwarding relevant documents to them.
- Creates and explains patient liability estimate for all scheduled and add-on procedures
- Contacts patient or physician offices when insurance information invalid or termed for all scheduled procedures
- Provides registration functions as needed
- Performs other duties as assigned
Job Requirements
- High school diploma or equivalent - Required
- Two years of college or medical office specialist education - Preferred
- Working knowledge of managed care and third party payors
- Minimum Work Experience
- One year experience with obtaining and verifying pre-certifications with various insurance companies Required.
- Requires critical thinking skills decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
- Must be able to function appropriately in a multi-task setting.
Why Choose Us:
We believe that investing in our employees is the first step to providing excellent patient addition to your base compensation this position also offers:
- Comprehensive Benefits:Multiple levels of medical dental and vision coverage for full-time andpart-time employees.
- Financial Protection & PTO:Life accident critical illness hospital indemnity insurance short- and long-term disability paid family leave and a minimum of 10 days of paid time off per year (for full time employees) as well as 8 paid holidays per year.
- Financial & Career Growth:Higher education and certification tuition assistance loan assistance and 401(k) retirement package and company match.
- Employee Well-being:Mental physical and financial wellness programs (free gym memberships virtual care appointments mental health services and discount programs).
- Professional Development:Ongoing learning and career advancement opportunities.
Who We Are:
People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Lourdes Hospital LLC offers a lifetime of care across a broad spectrum of healthcare specialties and fact weve built what has become one of Eastern Washingtons largest multi-specialty medical groups.
Where We Are:
Positioned in the heart of Washington wine and agriculture country the Tri-Cities area is known for a plethora of sunshine and four predominantly mild seasons. The three major rivers multiple nearby mountain ranges and beautiful sun-soaked valleys offer endless natural beauty and year-round outdoor recreational opportunities.
EEOC Statement:
Lourdes Hospital LLC is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color race sex age religion national origin disability genetic information gender identity sexual orientation veterans status or any other basis protected by applicable federal state or local law.
Required Experience:
IC
Key Skills
- Sales Experience
- Time Management
- Marketing
- Customer Service
- Communication skills
- Retail Sales
- Business Management
- Outside Sales
- Telemarketing
- Insurance Sales
- Medicare
- Phone Etiquette
About Company
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 a ... View more
