Insurance Verification Pro: Fast Authorizations & Benefits

Socket.dev; Costa Mesa (CA); On-site; USD 42,000 - 68,000; Full time

Job summary

Hoag Memorial Hospital Presbyterian is actively seeking an Insurance Verification Specialist to verify coverage and benefits, obtain authorizations, and ensure timely reimbursement for services. The role involves working with patients, insurance companies, and clinical departments to support accurate billing and medical necessity.

Responsibilities include reviewing orders, educating patients on benefits, and maintaining accurate data in the billing system, with collaboration across departments

Qualifications

• Experience in insurance verification and benefit coverage.
• Strong understanding of authorizations and medical necessity.
• Ability to code accurately in billing systems.
• Excellent patient communication and education skills.

Responsibilities

• Verify insurance coverage and benefits for services in assigned department(s).
• Obtain prior authorizations and ensure timely reimbursement.
• Review physician orders for medical necessity and accuracy.
• Provide patient education on services, benefits, and authorization status.
• Enter insurance benefit and authorization data into patient accounts.
• Coordinate with physicians and insurance companies as needed.

Skills

Insurance verification

Medical necessity reviews

Authorization processes

Patient education

Billing system coding

Communication with patients/insurance

Peer-to-peer evaluations

Job description

Hoag Memorial Hospital Presbyterian is actively seeking an Insurance Verification Specialist to verify coverage and benefits, obtain authorizations, and ensure timely reimbursement for services. The role involves working with patients, insurance companies, and clinical departments to support accurate billing and medical necessity.

Responsibilities include reviewing orders, educating patients on benefits, and maintaining accurate data in the billing system, with collaboration across departments