Insurance Coordinator (Healthcare)

Insurance Coordinator
The Insurance Coordinator is responsible for verifying insurance and managed care plans to determine patient eligibility across all listed insurance providers. They handle authorizations submissions and follow-ups, ensuring approval for necessary treatments and documenting outcomes in patient accounts. Additionally, they directly contact patients regarding insurance discrepancies and obtain referrals as per insurance plan requirements, while maintaining data integrity protocols in managing insurance records. The Insurance Coordinator also serves as a key resource for staff, answering authorization questions, updating them on insurance plan changes, and ensuring accuracy in patient balances for upcoming appointments.

This is a Remote position; however, all candidates considered for this position must currently reside within Central California (Bakersfield area preferred).

Duties / Responsibilities

Verifies insurance/managed care plans for eligibility for all insurance plans listed in the patient account
Handles Authorizations submissions and follow-ups for all assigned insurance payors to confirm eligibility and/or contacts the payer directly and documents the outcome in the patient account
Contacts patients directly when insurance has terminated or shows ineligible in attempts to obtain current information prior to office visits
Will pre-certify all patient testing, procedures, and injections by confirming their insurance/managed care plan eligibility in addition to confirming whether prior authorization for visits and treatments are necessary
Enter referrals/authorization information into Practice Management software
Obtains and/or advises patients of the need for referrals as indicated on their insurance plan, i.e., BCBS, Aetna, Oxford, HIP, and/or HCP
Obtains all Healthcare Partners referrals for existing patients providing all clinical documents, as necessary
Follow and maintain data integrity protocols in adding/editing patients' insurance records
Answers authorization questions and requirements for all payers to assist clinical and front office staff
Advises staff of any insurance plan updates
Checks patient balances on upcoming appointments for accuracy and presents to the front desk to collect
Perform other duties as required