Insurance Verification & Authorization Specialist

Shriners Children's; Sacramento (CA); On-site; USD 40,000 - 57,000; Full time

Job summary

Shriners Children's is seeking an Insurance Verification Specialist to coordinate authorizations for services in Northern California. The role involves verifying eligibility, communicating pre-authorizations, and maintaining accurate benefit information within the electronic medical record system.

The ideal candidate will have knowledge of major insurance plans (HMO, PPO, Medi-Cal, CCS) and strong medical terminology to liaise with patients, providers and insurers.

Qualifications

• Knowledge of health care insurance systems (HMO, PPO, Medi-Cal, CCS) and third-party payers.
• Medical terminology to communicate with patients, providers and insurers.
• Proficient with Microsoft Office (Word, Excel, Outlook).
• Desirable: experience in insurance verification or medical billing.

Responsibilities

• Obtain and communicate pre-authorizations as required by insurance.
• Verify patient insurance eligibility and benefits.
• Review admission information, service type and treatment codes for authorization needs.
• Track and obtain authorizations from various carriers in a timely manner.
• Notify supervisor of potential insurance coverage issues and seek input as needed.

Skills

Insurance verification

Medical terminology

Microsoft Office

Insurance eligibility

Authorization tracking

Education

High School Diploma/GED

Tools

Electronic Medical Records

Job description

Shriners Children's is seeking an Insurance Verification Specialist to coordinate authorizations for services in Northern California. The role involves verifying eligibility, communicating pre-authorizations, and maintaining accurate benefit information within the electronic medical record system.

The ideal candidate will have knowledge of major insurance plans (HMO, PPO, Medi-Cal, CCS) and strong medical terminology to liaise with patients, providers and insurers.