Insurance Verification Specialist

Exciting Opportunity for a Full Time Insurance Verification Specialist On Site

Monday -Friday

8:30am-5pm

Overview of responsibilities (day-to-day, metrics, etc)

1. Obtain accurate health insurance benefits verification of eligibility status
2. Assist with authorizations using electronic verification systems or by contacting payers directly to determine level of insurance coverage
3. Ensure pre-registration process is complete for all assigned accounts at least 7 days prior to the scheduled date of service, whenever possible
4. Identify co-payments, coinsurance, and policy limitations; advise patient and collect amount before the time of service
5. Follow up on missing authorizations
6. If authorization is not obtained within 48 hours prior to service, contact patient to advise them of their options for rescheduling/follow-up with physician's office or proceeding without authorization

3-5 Must Have Skills/Qualifications

• Experience in interpreting insurance benefits
• 2+ years of previous experience in insurance authorizations
• Ability to verify / determine if authorization was run correctly (determining proper CPT codes)
• Basic level understanding of medical scheduling (knowledge of normal procedure lengths)

Nice to Have Skills

• Prior authorization experience in an HB setting
• Medical scheduling in at least a small medical office
• Medical billing experience
• Previous medical call center experience

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.