Insurance Specialist

Your experience matters Memorial Medical Center 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.

How you'll contribute An Insurance Specialist who excels in this role:

• Verifies and documents insurance benefits, secures pre-certification/referral numbers and estimates/collects patient liabilities on all outpatient scheduled procedures.
• 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 appointments
• 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 estimates 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.

What we’re looking for Education :

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

Skills & 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.
• Working knowledge of managed care and third-party payors.

Schedule : Full-time

Why join 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 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.

More about Memorial Medical Center Memorial Medical Center is a 199-bed acute medical/surgical teaching hospital located in Las Cruces, NM, and 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.