Insurance Specialist

Memorial Medical Center Las Cruces; Las Cruces (NM); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Comprehensive Benefits

Life & Disability Insurance

401(k) retirement plan

Education support

Well-being programs

Job summary

Memorial Medical Center Las Cruces is seeking an Insurance Specialist to verify insurance benefits and secure pre-certifications for outpatient procedures. The role involves extensive contact with payers, physicians, and scheduling teams to ensure timely, accurate patient coverage and clear liability estimates.

The ideal candidate has at least one year of pre-certification experience, strong critical thinking, and the ability to work under pressure in a multi-task environment.

Qualifications

• Verifies and documents insurance benefits for outpatient procedures.
• Obtains pre-certifications and estimates patient liabilities.
• Notifies clinics when pre-certification is missing or late.
• Handles heavy phone and payer website communication.
• Maintains knowledge of outpatient imaging policies.

Responsibilities

• Conduct insurance verification and pre-certification for outpatient procedures.
• Explain patient liability estimates.
• Communicate with physician offices and scheduling with insurance requirements.
• Provide registration functions as needed.

Skills

Insurance verification

Pre-certification

Payer communications

Outpatient scheduling

Customer service

Education

High school diploma or equivalent

Two years of college or medical office education (preferred)

Tools

Payer websites

Insurance eligibility tools

Job description

Your Experience Matters

Memorial Medical Center is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As an

Your Experience Matters

Memorial Medical Center is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As an Insurance Specialist, joining our team, you’re embracing a vital mission dedicated to making communities healthier®. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

How You’ll Contribute

• Verifies and documents insurance benefits, secures pre-certification/referral numbers and estimates/collects patient liabilities on all outpatient scheduled procedures.
• 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 appointments
• 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 estimates 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.

Education

• High school diploma or equivalent is required.
• Two years of college or medical office specialist education - Preferred.

What We’re Looking For

• 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.
• Working knowledge of managed care and third‑party payors.

Skills & 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.
• Working knowledge of managed care and third‑party payors.

Schedule

Full‑time

Why join us

We Believe That Investing In Our Employees Is The First Step To Providing Excellent Patient Care. In Addition To Your Base Compensation, This Position Also Offers

• Comprehensive Benefits:Multiple levels of medical, dental and vision coverage for full‑time and part‑time employees.
• Financial Protection & PTO:Life, accident, critical illness, hospital indemnity insurance, short‑and long‑term disability, paid family leave and paid time off.
• 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.

More About Memorial Medical Center

Memorial Medical Center is a 199-bed acute medical/surgical teaching hospital located in Las Cruces, NM, and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier® with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your first day to your next career milestone-your experience matters.

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 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post‑acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.

EEOC Statement

Memorial Medical Center is an Equal Opportunity Employer. Memorial Medical Center is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.