Insurance Verification & Authorization Specialist

aa067; South Pasadena (CA); On-site; USD 52,000 - 78,000; Full time

Job summary

City of Hope is seeking an Insurance Specialist/Auditor to verify patient insurance, obtain authorizations, and assist with pre-registration and patient communication. This role requires independent judgment to coordinate complex managed care and private insurance authorizations, and to work across ARIA and EPIC EMR systems.

The successful candidate will educate patients on insurance policies, verify eligibility, and coordinate with physicians, payors, and hospital departments to ensure timely

Qualifications

• High School Diploma is required.
• Three years related healthcare pre-registration/referral experience is required.
• Medical terminology and electronic medical record experience are required.

Responsibilities

• Identify insurance companies requiring prior authorization for services and obtain authorization.
• Coordinate authorizations for procedures and testing requested by providers for patient care.
• Educate patients about their insurance policies and compose letters to insurers for authorization or appeals.
• Maintain current records on managed care patients in ARIA and EPIC EMR systems.
• Perform pre-registration tasks including demographics, clinical and financial info verification for appointments.
• Communicate with patients, payers, and staff to verify insurance and demographic information and resolve issues.

Skills

Insurance verification

Prior authorization

Medical terminology

EMR familiarity

Education

High School Diploma

Job description

City of Hope is seeking an Insurance Specialist/Auditor to verify patient insurance, obtain authorizations, and assist with pre-registration and patient communication. This role requires independent judgment to coordinate complex managed care and private insurance authorizations, and to work across ARIA and EPIC EMR systems.

The successful candidate will educate patients on insurance policies, verify eligibility, and coordinate with physicians, payors, and hospital departments to ensure timely