Insurance Verification Specialist II

1 day ago


Irvine, California, United States Hoag Memorial Hospital Presbyterian Full time
Job Summary

We are seeking a highly skilled Insurance Verification Specialist II to join our team at Hoag Memorial Hospital Presbyterian. As a key member of our patient access team, you will play a critical role in ensuring timely reimbursement of services and providing exceptional patient care.

Key Responsibilities
  • Verify insurance coverage and benefits for patients in assigned departments
  • Obtain proper authorizations and ensure timely reimbursement of services
  • Review physician orders for medical necessity and accuracy
  • Provide clinical documentation to support proper authorization
  • Accurately code insurance in the billing system
  • Communicate with patients regarding service benefits, status of pending or denied authorizations, and resolve any issues
  • Determine copayment and deductible amounts, maintain charge entry, and reconcile daily charges
  • Enter insurance benefits and authorization information into patient accounts
  • Oversee a larger volume or variety of accounts and serve as a direct liaison between insurance carriers and our organization
  • Monitor day-to-day inventory to ensure insurance authorization is in place before services are rendered
Requirements
  • High school diploma or equivalent required
  • Two to three years' experience in patient access or related healthcare experience required
  • One year of experience in Insurance Verification required
  • Intermediate knowledge of Windows computers and data entry required
  • Experience with billing, insurance verification, coding, authorization guidelines, ICD 10 and CPT-4 coding, and/or medical terminology preferred
What We Offer

Hoag Memorial Hospital Presbyterian is an Equal Opportunity Employer and is committed to providing a work environment free of discrimination and harassment. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.



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