Insurance Specialist

Memorial Physician Practices; Price, Northern (UT, KY); Hybrid; USD 22,000 - 29,000; Full time

Benefits offered by this job

Comprehensive benefits

Paid time off

Tuition assistance

Job summary

Castleview Hospital is seeking an Insurance Specialist to verify insurance benefits, secure pre-certifications, and estimate patient liabilities for outpatient procedures. The role involves heavy payer contact and coordination with physician offices to ensure timely pre-certifications and accurate documentation.

Qualified candidates will have a high school diploma and preferably two years of related medical office education.

Qualifications

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

Responsibilities

• Verifies insurance benefits and eligibility for outpatient procedures.
• Obtains pre-certifications/referral numbers for scheduled surgeries and communicates timing to offices.
• Interfaces with payers to resolve CPT code discrepancies and radiologist-related changes.
• Performs insurance verification for outpatient procedures and estimates patient liabilities.
• Maintains knowledge of outpatient imaging policies and billing practices.

Skills

Insurance verification

Pre-certification

Patient liability estimate

Payer communications

Education

High school diploma or equivalent

Two years of college or medical office education preferred

Job description

Your experience matters

Castleview Hospital 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

The Insurance Specialist 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.

An Insurance Specialist who excels in this role:

• 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 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

What we\'re looking for

• High school diploma or equivalent - Required


• Two years of college or medical office specialist education preferred

Schedule

Full-time, Monday-Friday 8am-4:30pm MST

Salary Range

$16-$21

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 andpart-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 Castleview Hospital

Castleview Hospital 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

EEOC Statement

\"Castleview Hospitalis an Equal Opportunity Employer.Castleview Hospitalis committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.\"