Insurance Specialist

Lourdes Hospital- 9915 Sandifur Parkway Office

Job Title: Insurance Specialist

Job Type: Full time Monday - Friday

Wage Range:  $17.90 - $24.84

*THIS IS NOT A REMOTE POSITION-MUST BE IN THE STATE OF WA*

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. FSLA: Non-exempt
 

ESSENTIAL FUNCTIONS
To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation.

• 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
• Performs other duties as assigned

Job Requirements

• High school diploma or equivalent - Required
• Two years of college or medical office specialist education - Preferred
• Working knowledge of managed care and third party payors
• Minimum Work Experience
• One year experience with obtaining and verifying pre-certifications with various insurance companies Required.
• 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. 

Why Choose Us:
We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:   

• 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 a minimum of 10 days of paid time off per year (for full time employees) as well as 8 paid holidays per year. 
• 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. 

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. Lourdes Hospital, LLC, offers a lifetime of care across a broad spectrum of healthcare specialties and services. In fact, we've built what has become one of Eastern Washington's largest multi-specialty medical groups. 
 

Where We Are:
Positioned in the heart of Washington wine and agriculture country, the Tri-Cities area is known for a plethora of sunshine and four predominantly mild seasons. The three major rivers, multiple nearby mountain ranges, and beautiful sun-soaked valleys offer endless natural beauty and year-round outdoor recreational opportunities.

EEOC Statement:

Lourdes Hospital, LLC 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.

Lifepoint Health is a leader in community-based care and driven by 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 more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.