Insurance Verification & Authorization Specialist

NOBEL Women; Costa Mesa (CA); Hybrid; USD 42,000 - 65,000; Full time

Job summary

Hoag Memorial Hospital Presbyterian is seeking an Insurance Verification Specialist to verify insurance coverage and benefits for services. The role involves working with patients, insurers, and clinical teams to secure authorizations and ensure timely reimbursement.

The position requires 2-3 years of healthcare access experience, familiarity with billing systems, ICD-10/CPT-4 coding, and strong data entry skills. Oncology-focused experience is particularly valued.

Qualifications

• High school diploma or equivalent required.
• Two to three years’ experience in patient access or related healthcare required.
• Experience with billing, insurance verification, coding, authorization guidelines, ICD-10 and CPT-4 coding, and/or medical terminology preferred.
• Degree and/or certificate in related field preferred.

Responsibilities

• Verify insurance coverage and obtain authorizations for assigned department(s).
• Verify physician orders for medical necessity and provide clinical documentation to support authorization.
• Code insurance accurately in the billing system.
• Educate patients on benefits, status of authorizations, and out-of-pocket costs.
• Determine copayment and deductible amounts; enter charges and reconcile daily.

Education

High school diploma or equivalent

Degree/certificate in related field preferred

Job description

Hoag Memorial Hospital Presbyterian is seeking an Insurance Verification Specialist to verify insurance coverage and benefits for services. The role involves working with patients, insurers, and clinical teams to secure authorizations and ensure timely reimbursement.

The position requires 2-3 years of healthcare access experience, familiarity with billing systems, ICD-10/CPT-4 coding, and strong data entry skills. Oncology-focused experience is particularly valued.