Insurance Verification Specialist

Pathnostics - A Diagnostics Solutions Company; Irvine (CA); Hybrid; USD 34,000 - 41,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life/AD&D

FSA/DCA and Pet Insurance

Hybrid schedule

Job summary

Pathnostics in Irvine, CA, is seeking a Billing Specialist I to verify insurance coverage and eligibility, working with providers and patients to keep claims compliant with payer and Medicare requirements. You will support timely access to care while coordinating with internal teams to resolve coverage issues and denials.

The role requires 1–3 years in insurance verification or related revenue cycle functions, familiarity with billing systems (Xifin/Experian OneSource a plus), and solid

Qualifications

• 1-3 years in insurance verification or related revenue cycle role.
• Familiarity with eligibility tools and computerized billing systems; Xifin or Experian OneSource a plus.
• Understanding payer lines of business and their effect on claim routing.
• Knowledge of CPT and ICD-10 coding.
• Strong analytical, problem-solving, and organizational skills; detail-oriented.
• Excellent written and verbal communication; capable of independent and collaborative work.
• High school diploma or equivalent; associate's or bachelor's degree preferred.

Responsibilities

• Verify insurance coverage and eligibility for patients in a lab setting.
• Review and prioritize orders requiring benefits investigation for timely processing.
• Confirm patient insurance information is accurate and current.
• Contact insurance carriers to verify eligibility, benefits, and plan type.
• Document payer interactions clearly with reference numbers and outcomes.
• Review accounts to ensure data accuracy; resolve issues as they arise.
• Collaborate with clients, payers, patients, and internal teams for coverage details with good customer service.
• Maintain confidentiality and HIPAA compliance.

Skills

Insurance verification

Eligibility tools

Billing systems

Payer knowledge (Medicare, Medicaid, C

Education

High school diploma or equivalent

Associate/Bachelor preferred

Tools

Xifin

Experian OneSource

Job description

Billing Specialist I, Insurance Verification | Pathnostics | Hybrid - Irvine, CA

Join Us in Moving Care Forward

Pathnostics is an innovative molecular diagnostics laboratory dedicated to improving patient outcomes through precision testing and science-driven insights. We're excited to bring on a new Insurance Verification Specialist to our revenue cycle team in Irvine, CA. This is a great opportunity to build your career with a company that's re-shaping the standard of care.

What We Offer

• $25.00 to $30.00 per hour, DOE
• Medical, Dental, Vision, Life/AD&D, and a portfolio of voluntary benefits including FSA/DCA and Pet Insurance
• Hybrid Schedule
• Supportive team environment with employee events planned throughout the year

About the Role

As a Billing Specialist I, you'll play a key role in making sure patients get timely access to care by accurately verifying insurance coverage and eligibility. You'll work closely with insurance providers, patients, clients, and internal teams to resolve coverage issues, reduce eligibility-related denials, and keep claims compliant with payer and Medicare requirements. Your work directly supports both patient experience and successful billing operations.

What You'll Do

• Verify insurance coverage and eligibility for patients in a laboratory setting
• Review and prioritize incoming orders requiring benefits investigation for timely processing
• Confirm patient insurance information is accurate, complete, and current
• Contact insurance carriers via provider portals and phone to verify eligibility, benefits, and plan type/line of business
• Document all payer interactions clearly and accurately, including reference numbers and outcomes
• Review accounts to ensure insurance, demographic, and eligibility data is entered correctly, resolving issues as they arise
• Partner with clients, payers, patients, and internal stakeholders to confirm coverage details with excellent customer service
• Maintain strict confidentiality and HIPAA compliance in all work

What You Bring

• 1-3 years of experience in insurance verification, medical billing, healthcare revenue cycle, patient financial services, claims processing, or a related administrative role (lab setting experience a plus)
• Familiarity with eligibility tools and computerized billing systems; experience with Xifin and/or Experian OneSource is a plus
• Understanding of payer lines of business (Medicare, Medicare Advantage, commercial, Medicaid) and how they affect claim routing
• Working knowledge of CPT and ICD-10 coding
• Strong analytical, problem-solving, and organizational skills with high attention to detail
• Excellent written and verbal communication skills
• Ability to manage a high volume of work independently and as part of a collaborative team
• High school diploma or equivalent required; associate's or bachelor's degree preferred

Why Pathnostics?

We're a growing molecular diagnostics company where your contributions have real impact on patients, providers, and the push toward personalized treatment options for patients in need. We're committed to building diverse, inclusive teams and offering opportunities to grow your career as we grow our operations.

Pathnostics is an equal opportunity employer and an E-Verify employer.