Insurance Verification & Pre-Cert 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

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.