Insurance Specialist

NOT A REMOTE POSITION

Schedule

Full-Time, Monday to Friday

Pay

$17.90 - $24.84/hourly

About the role

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 this role, you'll support those 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.

Responsibilities

• Verification and documentation of insurance benefits.
• Securing pre-certification and referral numbers.
• Estimating and collecting patient liabilities for all outpatient scheduled procedures.
• Ensuring pre-certifications required by managed care companies for scheduled surgeries and procedures are obtained on a timely basis and documented in advance of appointments.
• Notifying physician offices and centralized scheduling if pre-certification is not obtained in time for the patient appointment.
• Heavy phone and payer website contact in accordance with payer pre-certification and verification regulations.
• Communicating with insurance payers regarding any CPT code discrepancies or changes made due to radiologist discretion.
• Performing insurance verification, eligibility, and pre-certification for outpatient scheduled procedures.
• Maintaining current knowledge of outpatient imaging policies and procedures.
• Verifying active insurance coverage and obtaining insurance benefits using insurance eligibility tools, payer websites, and payer phone systems.
• Communicating with Benefits and Notification Specialist whenever a patient has no verifiable insurance benefits to cover a scheduled procedure.
• Working closely with physician offices and hospital departments when obtaining clinical information, providing necessary information, or forwarding relevant documents.
• Creating and explaining patient liability estimates for all scheduled and add-on procedures.
• Contacting patients or physician offices when insurance information is invalid or terminated for all scheduled procedures.
• Providing registration functions as needed.
• Performing other duties as assigned.

Requirements

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

Benefits

• 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 with company match.
• Employee Well-being: Mental, physical, and financial wellness programs, including free gym memberships, virtual care appointments, mental health services, and discount programs.
• Professional Development: Ongoing learning and career advancement opportunities.

Lourdes Health is part of Lifepoint Health, a leader in community-based care with 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 over 170 additional sites of care.