Pediatrics Insurance Specialist: Verifications

momentum-formerly-ucpla; Torrance (CA); On-site; USD 52,000 - 65,000; Full time

Benefits offered by this job

Medical/Dental/Vision Insurance

Life Assistance Program

FSA

Paid Holidays

Paid Vacation/Sick/Bereavement leave

Credit Union Benefits

403B Retirement Plan

Direct Deposit

Job summary

Momentum is seeking an Insurance Specialist for our pediatrics department. The role verifies benefits, obtains authorizations, and ensures all information is received for insurance carriers.

You will collaborate with Scheduling Administrators, Accounting, and Therapy Directors to maintain funding and coverage. Qualifications include a high school diploma (Bachelor’s preferred), 2+ years in healthcare, ICD-10/CPT knowledge, and proficiency with EMR systems.

Qualifications

• High school diploma required; Bachelor’s degree preferred.
• Minimum of two years’ experience in a healthcare or therapeutic setting.
• Knowledge of patient benefits and plan coverage; funding knowledge required.
• Experience with ICD-10 and CPT codes.
• Ability to lift up to 25 pounds.
• Valid California driver’s license preferred, not required.

Responsibilities

• Verifies insurance benefits.
• Obtains authorizations and requests information to ensure funding for all accepted insurance carriers.
• Enters new and updated insurance/funding information into the EMR system.
• Contacts families regarding eligibility of benefits or changes in plans, including tracking plan effective dates.
• Obtains updated insurance card and information from participating families.
• Tracks, routes, and submits therapy reports to funding source for reauthorization, while monitoring funding end dates to ensure continued coverage.
• Provides administrative support to the Scheduling Administrators and Department Manager(s), as needed.
• Performs other duties as assigned to meet department and/or business needs.

Skills

ICD-10 CPT codes

Benefits knowledge

Detail oriented

Communication

Confidentiality

Healthcare experience

Education

Bachelor's degree

High school diploma

Tools

EMR system

Job description

Momentum is seeking an Insurance Specialist for our pediatrics department. The role verifies benefits, obtains authorizations, and ensures all information is received for insurance carriers.

You will collaborate with Scheduling Administrators, Accounting, and Therapy Directors to maintain funding and coverage. Qualifications include a high school diploma (Bachelor’s preferred), 2+ years in healthcare, ICD-10/CPT knowledge, and proficiency with EMR systems.