Job: Reimbursement Specialist
Schedule: PRN (ONLY AS NEEDED)
Your experience matters
Community Medical Center is operated jointly with Lifepoint Health. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Supply Chain Technician joining our team, you're embracing our promise to provide superior patient care that exceeds industry standards as well as patient expectations. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.
Job Summary:
An Reimbursement Speicalist is responsible for ensuring that all oncology-related services, procedures, and treatments are properly authorized or pre-certified before they are rendered, in compliance with insurance and payer requirements.
How you''ll contribute:
A Reimbursement specialist who excels at this role:
Verify that oncology services meet pre-certification or pre-authorization requirements before treatment begins.
Confirm patient insurance eligibility and benefits, ensuring coverage for scheduled oncology procedures and/or medications, radiology imaging and surgeries.
Complete and submit accurate third-party payer authorization requests, including gathering and verifying CPT codes, diagnosis codes, and other required data elements.
Communicate with oncology physicians, nurse practitioners, and ancillary departments to obtain necessary documentation and physician orders.
Record authorization approvals or denials in the electronic health record (EHR) and ensure all required signatures are obtained for treatments.
Provide clear information to patients about authorization status, costs, and any required pre-payments.
What we are looking for:
Education: High school diploma or equivalent required; preferred post-secondary courses in medical terminology, diagnosis, CPT coding, anatomy & physiology; or a medical assistant, health unit coordinator, or healthcare business service program.
Experience: Minimum 2 years in a medical business office or healthcare setting with patient-facing responsibilities; prior authorization experience preferred.
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:
EEOC Statement:
Community Medical Center is an Equal Opportunity Employer. Community Medical Center is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment."
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.