Specialist, Insurance
Listed on 2026-01-02
-
Healthcare
Healthcare Administration, Medical Billing and Coding
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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.
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…
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.
- Performs other duties as assigned
Minimum Requirements
Education
- High school diploma or equivalent - Required.
- Two years of college or medical office specialist education - Preferred
- Requires critical thinking…
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