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Your next career move matters. We invite you to explore open positions at North Alabama Medical Center, which is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier® and creating places where employees want to work. Whether you're an experienced professional or just beginning your career, you'll find opportunities to use your skills and expertise.

Specialist, Insurance

Florence, Alabama

Req ID 302814 Post Date May. 06, 2025 CategoryRevenue Cycle Management FacilityNorth Alabama Medical Center
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North Alabama Medical Center

Job Title: Specialist, Insurance
Job Type: Full Time

Who We Are:
People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. North Alabama Medical Center is a 263 bed facility offering the community’s only open heart surgery site, a complete line of women’s and children’s services and a complete line of medical and imaging services. We are a Certified Chest Pain center and recognized as a Primary Stroke Center of Excellence by the American Heart/American Stroke Association. North Alabama Medical Center’s 24-hour emergency department serves as the primary referral center for major trauma cases in Northwest Alabama.

Where We Are:
No matter what type of things you’re interested in, we have things of interest for you. Florence is a vibrant area with walkable streets and plenty of inspiring things to do. Spend your days getting to know the local community by exploring our shops, restaurants, and historical attractions.

Why Choose Us:
·    Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
·    Competitive Paid Time Off
·    Employee Assistance Program – mental, physical, and financial wellness assistance
·    Tuition Reimbursement/Assistance for qualified applicants
·    Discounted membership rates at local fitness centers
·    Continuing education opportunities
·    And much more…

Position Summary:

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.

Reports to: Patient Access Supervisor
FLSA: Non-exempt

Essential Functions

  • 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 appointment.
  • 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.

Non-Essential Functions

  • Performs other duties as assigned

Minimum Requirements

Education

  • High school diploma or equivalent - Required.
  • Two years of college or medical office specialist education - Preferred

Skills

  • Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
  • Must be able to work in a stressful environment and take appropriate action. 
  • Must be able to function appropriately in a multi-task setting.
  • Working knowledge of managed care and third party payors

Work Experience

  • One year experience with obtaining and verifying pre-certifications with various insurance companies Required.

EEOC Statement:
North Alabama Medical Center is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.

We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.

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