Insurance Specialist

Lifepoint Health • Pasco, WA

1d • $18 - $25 • Onsite

About The Position

At Lourdes Health, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. In your role, you’ll support those that are in our facilities who are interfacing and providing care to our patients and community members. We believe that our collective efforts will shape a healthier future for the communities we serve.

How you'll contribute: 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.

Requirements

• High school diploma or equivalent - Required
• One year experience with obtaining and verifying pre-certifications with various insurance companies Required.

Nice To Haves

• Two years of college or medical office specialist education - Preferred

Responsibilities

• 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

Benefits

• Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
• Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Ongoing learning and career advancement opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED