Insurance Specialist

momentum-formerly-ucpla; Torrance (CA); On-site; USD 52,000 - 65,000; Full time

Benefits offered by this job

Medical/Dental/Vision Insurance

Life Assistance Program

FSA

Paid Holidays

Paid Vacation/Sick/Bereavement leave

Credit Union Benefits

403B Retirement Plan

Direct Deposit

Job summary

Momentum is seeking an Insurance Specialist for our pediatrics department. The role verifies benefits, obtains authorizations, and ensures all information is received for insurance carriers.

You will collaborate with Scheduling Administrators, Accounting, and Therapy Directors to maintain funding and coverage. Qualifications include a high school diploma (Bachelor’s preferred), 2+ years in healthcare, ICD-10/CPT knowledge, and proficiency with EMR systems.

Qualifications

• High school diploma required; Bachelor’s degree preferred.
• Minimum of two years’ experience in a healthcare or therapeutic setting.
• Knowledge of patient benefits and plan coverage; funding knowledge required.
• Experience with ICD-10 and CPT codes.
• Ability to lift up to 25 pounds.
• Valid California driver’s license preferred, not required.

Responsibilities

• Verifies insurance benefits.
• Obtains authorizations and requests information to ensure funding for all accepted insurance carriers.
• Enters new and updated insurance/funding information into the EMR system.
• Contacts families regarding eligibility of benefits or changes in plans, including tracking plan effective dates.
• Obtains updated insurance card and information from participating families.
• Tracks, routes, and submits therapy reports to funding source for reauthorization, while monitoring funding end dates to ensure continued coverage.
• Provides administrative support to the Scheduling Administrators and Department Manager(s), as needed.
• Performs other duties as assigned to meet department and/or business needs.

Skills

ICD-10 CPT codes

Benefits knowledge

Detail oriented

Communication

Confidentiality

Healthcare experience

Education

Bachelor's degree

High school diploma

Tools

EMR system

Job description

Momentum is currently hiring an **Insurance Specialist ******for our pediatrics department. The Insurance Specialist is responsible for verifying benefits, obtaining authorizations, and ensuring all required information is received for all insurance carriers. The Insurance Specialist works closely with the Scheduling Administrators, Accounting department, and Therapy Directors. The Insurance Specialist must have great knowledge and understanding of patient benefits, plan coverage, and obtaining funding.

Benefits (Full-time):

• Medical/Dental/Vision Insurance
• Life Assistance Program
• Flexible Spending Account (FSA)
• Paid Holidays
• Paid Vacation/Sick/Bereavement leave
• Credit Union Benefits and Discounts
• Retirement Plan (403B)
• Direct Deposit

Insurance Specialist Essential Responsibilities:

• Verifies insurance benefits
• Obtains authorizations and requests information to ensure funding for all accepted insurance carriers
• Enters new and updated insurance/funding information into the EMR system
• Contacts families regarding eligibility of benefits or changes in plans, including tracking plan effective dates
• Obtains updated insurance card and information from participating families
• Tracks, routes, and submits therapy reports to appropriate funding source for reauthorization, while monitoring funding end dates to ensure continued coverage
• Provides administrative support to the Scheduling Administrators and Department Manager(s), as needed
• Performs other duties as assigned to meet departments and/or business needs

Insurance Specialist Qualifications:

• High school diploma, required; Bachelor’s degree in related field, preferred
• Minimum of two (2) years’ experience in a healthcare or therapeutic setting; required
• Knowledge and understanding of patient benefits and plan coverage, and how to obtain funding; required
• Experience with ICD 10 and CPT codes; required
• Strong attention to detail and highly organized
• Ability to maintain confidentiality
• Communicate and work professionally and cooperatively with others
• Successfully pass all post offer, pre-employment screening requirements, including criminal background check and provide proof of eligibility to work in the United States
• Ability to walk, bend, squat, kneel, and lift up to twenty-five (25) pounds
• Valid and current proof of legal right to drive in California; preferred, not required

With 40 programs and service sites spanning several counties, Momentum is the largest nonprofit provider of direct support for individuals with developmental and intellectual disabilities in Southern California.

Momentum is an equal opportunity employer and is required to comply with equal opportunity legislation in each jurisdiction in which it operates. Momentum also considers qualified applicants with criminal histories for employment pursuant to California Law and, if applicable, the L.A. Fair Chance Ordinance.