Insurance Verification & Authorization Specialist

Hoag Health System; Costa Mesa (CA); On-site; USD 48,000 - 62,000; Full time

Job summary

Hoag Memorial Hospital Presbyterian is seeking an Insurance Verification Specialist in Orange County, CA. You will verify insurance coverage for services, obtain authorizations, and assist in ensuring timely reimbursement.

The role involves reviewing orders for medical necessity, educating patients about benefits, and accurately entering insurance data and codes in the billing system. Experience in healthcare payer processes is preferred.

Qualifications

• High school diploma or equivalent required.
• Two to three years’ experience in patient access or related healthcare experience required.
• Intermediate knowledge of Windows computers and data entry 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 and benefit coverage for services in assigned department(s).
• Obtain proper authorizations and ensure timely reimbursement of services.
• Provide patient education on benefits, status of pending or denied authorizations, and assist in resolving issues.
• Accurately code insurance in the billing system and enter insurance benefit and authorization information into patient accounts.

Skills

Patient access experience

Windows data entry

Billing & insurance verification

ICD-10 / CPT-4 coding

Medical terminology

Data entry

Education

High school diploma or equivalent

Degree or certificate in related field preferred

Tools

Windows OS

Job description

Hoag Memorial Hospital Presbyterian is seeking an Insurance Verification Specialist in Orange County, CA. You will verify insurance coverage for services, obtain authorizations, and assist in ensuring timely reimbursement.

The role involves reviewing orders for medical necessity, educating patients about benefits, and accurately entering insurance data and codes in the billing system. Experience in healthcare payer processes is preferred.