Insurance Specialist

Lifepoint Health, Inc.; Pasco (WA); Vor Ort; USD 25.000 - 34.000; Vollzeit

Zusammenfassung

Lourdes Health, located in Washington state, is seeking an Insurance Specialist to verify benefits, obtain pre-certifications, and estimate patient liabilities for outpatient procedures. This full-time, on-site role involves heavy payer contact and collaboration with physician offices to ensure timely admissions.

You will review coverage, explain patient responsibilities, and support registration while staying current on imaging policies and payer requirements.

Qualifikationen

• High school diploma or equivalent required.
• Two years of college or medical office specialist education preferred.
• One year experience with obtaining and verifying pre-certifications with various insurance companies required.

Aufgaben

• Ensure pre-certifications for scheduled surgeries are obtained timely and documented before appointments.
• Notify physician offices and scheduling if pre-cert is not obtained in time.
• Heavy phone and payer website contact in line with regulations.
• Communicate with insurance payers regarding CPT code discrepancies or changes due to radiologist discretion.
• Perform insurance verification, eligibility and pre-certification for outpatient procedures.
• Maintain current knowledge of outpatient imaging policies and procedures.
• Verify active insurance coverage and obtain benefits using eligibility tools, payer websites, and phone systems.
• Inform Benefits/N​​otification Specialist when a patient has no verifiable insurance benefits.
• Collaborate with physician offices and hospital departments to obtain clinical information and forward documents as needed.
• Create and explain patient liability estimates for scheduled and add-on procedures.
• Contact patients or offices if insurance information is invalid or terminated.
• Provide registration functions as needed.
• Perform other duties as assigned.

Kenntnisse

Insurance verification

Pre-certification

Communication skills

Ausbildung

High school diploma or equivalent

Two years of college or medical office education

Jobbeschreibung

Insurance Specialist

Job Schedule: Full-Time Monday to Friday

Wage: $17.90 - $24.84/hourly

*NOT A REMOTE POSITION*

Your experience matters at Lourdes Health

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.
Reports to: Patient Access Supervisor FLSA: Non-exempt

• 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
  

What we're looking for:

• High school diploma or equivalent - Required
• Two years of college or medical office specialist education - Preferred
• One year experience with obtaining and verifying pre‑certifications with various insurance companies Required.

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.

EEOC Statement

"Lourdes Health is an Equal Opportunity Employer. Lourdes Health is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment."

Employer Description

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

Pay Transparency Notice (Washington State)

If you believe this job posting does not include accurate or complete pay information in accordance with the Washington State Equal Pay and Opportunities Act, please inform us immediately. You can contact us at 833-271-4269 to report the issue. For more information on your rights under Washington's pay transparency laws, visit the Washington State Department of Labor and Industries website at: https://lni.wa.gov

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.