Lyons Medical Center is looking for an ideal candidate to fill a full time Insurance Specialist position. The ideal candidate would have a strong understanding of insurance and the insurance process.
Competitive salary and excellent benefits are offered.
Candidates are required to pass a background check, a pre-employment physical, and a drug screen. HIPAA compliance is mandatory for all employees of the healthcare system.
Job Summary: In charge of insurance related duties such as verifying coverage, benefit reviews, authorizations, etc. and communicating insurance information to patients effectively. Performs duties for both Lyons and Sterling Medical Centers.
Supervision Received: Reports to the Office Manager
Supervision Exercised: None
Typical Working Conditions/Physical Demands: Work is preformed in an office environment. Contact with staff, patients and outside businesses. Requires prolonged standing or sitting. Requires frequent bending, stooping and/or stretching. Will require lifting and carrying items up to 50 pounds. Requires eye-hand coordination and manual dexterity. Requires the ability to distinguish letters, numbers and symbols. Requires the use of office equipment such as computers, telephones, copiers, fax machines. Requires the ability to distinguish the numbers and colors of the charts. Requires vision correctable to 20/20 and the absence of color blindness to be able to read and distinguish the numbers and colors of the charts. Requires hearing within normal range for telephone use.
Examples of Duties:
- Review charge master fees vs. payer allowable to review for need for fee updates.
- Research system claims issues, including working with eCW for resolution.
- Monitor payer changes by attending payer specific webinars and meetings.
- Prior authorizations for radiology and procedures. Assists with medication prior authorizations.
- Assist front office staff with eligibility reports.
- Assist patients with insurance issues and questions.
- Generate cost estimates for private pay patients.
- Work on claim denials directly with payers and patients.
- Facilitate insurance verification and establish payment plans for OB patients.
- Set up insurance profiles in the EHR.
- Work with CBO on system set up, changes, and claim denials.
- Review/approve insurance and patient refunds.
- BCBS provider QBRP information re verification (Blue Access)
- Complete insurance specific surveys.
- Kancare presumptive eligibility.
- Work with coders and office manager to develop and write coding and billing guidelines.
- Other duties as assigned
Performance Requirements: Understands and performs with strict patient confidentiality. Works in an office environment. Must have good oral and written communication skills, and be detail oriented. Periods of filing records require standing, bending, stooping, stretching and reaching. Must be able to operate computer, copier, fax machine and other standard office equipment.
Education: High School Diploma
Experience: One year experience in medical setting, with insurance knowledge preferred.
Send a cover letter and resume to firstname.lastname@example.org or download and print the Employment Application. The application can be delivered in person or mailed to
Rice County District Hospital
Attn: Human Resources
619 South Clark
Lyons, KS 67554
Rice Community Healthcare does not discriminate employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.