Insurance Specialist

MOUNTAIN VIEW HOSPITAL LLC • Idaho Falls, ID

2d • Onsite

About The Position

Mountain View Hospital is hiring an Insurance Specialist to support the admission, scheduling, rescheduling, and discharge of physical therapy patients. The role collects and accurately enters patient, demographic, and insurance information; confirms that diagnoses support medical necessity; verifies insurance benefits; and ensures that required preauthorizations are completed before treatment. The Insurance Specialist works with patients, therapists, referring providers, insurance carriers, and the Billing Office to coordinate authorizations, payment arrangements, denials, collections, and continuity of care. The position also maintains patient records and department reports, handles appointment communications, and protects patient confidentiality.

Requirements

• High school diploma or GED.
• One to three months of related experience and/or training, or an equivalent combination of education and experience.
• Ability to use a hospital information system and perform basic computer functions and use software.
• Ability to read and interpret safety rules, operating and maintenance instructions, and procedure manuals.
• Ability to speak effectively before groups of customers or employees.
• Ability to perform arithmetic with whole numbers, fractions, and decimals, compute rate ratios and percentages, and draw and interpret bar graphs.

Nice To Haves

• Good working knowledge of Microsoft Office.

Responsibilities

• Register new physical therapy patients and obtain or verify demographics, insurance information, and emergency contacts.
• Communicate clearly and appropriately with patients, supervisors, nurse managers, coworkers, physicians, referring providers, insurers, and therapy staff.
• Collect required co-pays, cost-shares, and deductibles; post receipts and prepare daily cash reports.
• Maintain department records, reports, forms, and files.
• Schedule and reschedule patient appointments and communicate schedule changes to patients and therapists.
• Discharge patient accounts and charts accurately.
• Assemble new patient charts, obtain prior physical therapy charts when needed, and ensure records and scanned documents are complete.
• Contact insurance carriers to verify benefits and obtain authorization for physical therapy services, and enter benefit information into the hospital system.
• Track treatment authorizations and submit requests for additional services as needed.
• Ensure patient history forms are completed properly.
• Organize prior-day billing sheets and check their accuracy and completeness before submission for charge entry.
• Prepare daily reports of outpatient physical therapy patients and units billed, and inpatient therapy patients.
• Verify diagnoses support medical necessity, obtain required precertification, and secure payment arrangements when necessary before therapy begins.
• Work with referring providers to assemble paperwork for authorizations, demonstrate medical necessity, or request retroauthorization.
• Work with the Billing Office on denials, collections, and month-end and month-opening procedures.
• Learn and follow hospital policies and maintain familiarity with available hospital services.
• Remain flexible and organized, function effectively in stressful situations, and multitask efficiently.
• Treat patients and families respectfully and maintain confidentiality of patient records.
• Maintain effective working relationships within the department and with other departments.
• Complete required educational programs and attend required in-service meetings and other meetings.
• Maintain accurate time-clock punches in accordance with hospital policy.
• Answer incoming facility calls professionally and promptly.
• Complete other duties as assigned or requested.
• Comply with PCI standards and company policies and procedures for payment-card acceptance and security.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Paid time off, including vacation, holidays, and sick days
• Medical paid time off
• Retirement plans, including a 401(k) with up to a 6% match
• Earned quarterly bonus program
• Education reimbursement program
• Discounts for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital

What This Job Offers

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