Insurance Specialist

About the role

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.

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.

Responsibilities

• Verification/documentation of insurance benefits, securing pre-certification/referral numbers and estimating/collecting patient liabilities on all outpatient scheduled procedures.
• Ensure 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.
• Notify 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.
• Communicate with insurance payers regarding any CPT code discrepancies or changes made due to radiologist discretion.
• Perform insurance verification, eligibility and pre-certification for outpatient scheduled procedures.
• Maintain current knowledge of outpatient imaging policies and procedures.
• Verify the patient has active insurance coverage and obtain insurance benefits utilizing insurance eligibility tools, payer websites and payer phone systems.
• Communicate with Benefits and Notification Specialist whenever a patient has no verifiable insurance benefits to cover a scheduled procedure.
• Work closely with physician offices and departments of the hospital when obtaining clinical information, providing them with necessary information or forwarding relevant documents to them.
• Create and explain patient liability estimate for all scheduled and add-on procedures.
• Contact patient or physician offices when insurance information is invalid or termed for all scheduled procedures.
• Provide registration functions, as needed.

Requirements

• 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

Pay

Salary range $16‑$21

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.