Insurance Specialist

Location: Pasco, WA
Schedule: Full-Time, Monday to Friday, Day shift

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. This is not a remote position.

Responsibilities

• Verify and document insurance benefits, secure pre-certification/referral numbers, and estimate/collect patient liabilities for all outpatient scheduled procedures.
• Ensure pre-certifications required by managed care companies for scheduled surgeries and procedures are obtained on a timely basis and documented in advance of appointments.
• Notify physician offices and centralized scheduling if pre-certification is not obtained in time for patient appointments.
• Maintain heavy phone and payer website contact in accordance with payer pre-certification 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 using 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 hospital departments when obtaining clinical information, providing necessary information, or forwarding relevant documents.
• Create and explain patient liability estimates for all scheduled and add-on procedures.
• Contact patients or physician offices when insurance information is invalid or terminated for all scheduled procedures.
• Provide registration functions as needed.
• Perform 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 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.

Pay

$17.90 - $24.84/hour

Employer

Lourdes Health is part of Lifepoint Health, a leader in community-based care driven by a mission of Making Communities Healthier. The network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and over 170 additional sites of care.