Insurance Coordinator

California Retina Consultants in; Bakersfield (CA); Remote; USD 50,000 - 70,000; Full time

Job summary

A leading healthcare provider is seeking an Insurance Coordinator in Central California (Bakersfield area preferred). The role involves verifying insurance eligibility, managing authorizations, and ensuring accurate patient records while providing key support to staff on insurance issues. This remote position serves as an integral part of ensuring patients receive necessary care with smooth administrative processes.

Qualifications

• Experience in healthcare insurance verification preferred.
• Strong communication skills required.
• Detail-oriented and organized.

Responsibilities

• Verifies patient insurance eligibility across all providers.
• Handles authorization submissions and patient communications.
• Maintains and updates insurance records accurately.

Skills

Data Integrity

Communication

Attention to Detail

Tools

Practice Management Software

Job description

Insurance Coordinator (Healthcare)

The Insurance Coordinator is responsible for verifying insurance and managed care plans to determine patient eligibility across all listed insurance providers. They handle authorization submissions and follow-ups, ensuring approval for necessary treatments and documenting outcomes in patient accounts. Additionally, they directly contact patients regarding insurance discrepancies and obtain referrals as per insurance plan requirements, while maintaining data integrity protocols in managing insurance records. The Insurance Coordinator also serves as a key resource for staff, answering authorization questions, updating them on insurance plan changes, and ensuring accuracy in patient balances for upcoming appointments.

This is a Remote position; however, all candidates considered for this position must currently reside within Central California (Bakersfield area preferred).

Duties / Responsibilities

1. Verifies insurance/managed care plans for eligibility for all insurance plans listed in the patient account
2. Handles Authorization submissions and follow-ups for all assigned insurance payors to confirm eligibility and/or contacts the payer directly and documents the outcome in the patient account
3. Contacts patients directly when insurance has terminated or shows ineligible in attempts to obtain current information prior to office visits
4. Pre-certifies all patient testing, procedures, and injections by confirming their insurance/managed care plan eligibility and whether prior authorization is necessary
5. Enters referrals/authorization information into Practice Management software
6. Obtains and/or advises patients of the need for referrals as indicated on their insurance plan, e.g., BCBS, Aetna, Oxford, HIP, HCP
7. Obtains all Healthcare Partners referrals for existing patients, providing all necessary clinical documents
8. Maintains data integrity protocols in adding/editing patients' insurance records
9. Answers authorization questions and requirements for all payers to assist clinical and front office staff
10. Advises staff of any insurance plan updates
11. Checks patient balances on upcoming appointments for accuracy and coordinates collection
12. Performs other duties as required