1-3 years of experience
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Employment Type:
Full time
Job Category:
Health Care Provider
(This job is no longer available)
Grad Date

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Job Description

To ensure the insurance verification process is completed on all scheduled surgeries, admissions, OP Radiology, and all other services as assigned. Process includes but is not limited to: Verification of insurance benefit coverage, authorization and or notifications sent to insurance or medical group. Possess knowledge of Deductible, Copay’s, and Coinsurance, CPT and Diagnosis/Procedure Codes. Effectively works within a team atmosphere, has strong customer service expertise, has ability to multi-task, and proficient computer skills.


Essential Functions
• Insurance Eligibility verified on all assigned patients.
• Verification service or procedure is a covered benefit under the patient’s plan.
• Obtain UR contact, initiate authorization, or verify if auth is required.
• Verify and document in the system the patient’s copay, co-insurance, and deductible if applicable.
• Coordinate with physician offices on pending authorizations, peer to peer requests, or as necessary.
• Prior to service and as needed, contact patients to notify them of pending or denied authorizations and
or for limited benefit coverage.
• Perform other duties as assigned.


Education, Training and Experience
Required: High School diploma or equivalent with three (2-3) years of patient access or related healthcare experience.
Preferred: 2-3 years hospital admitting experience

Skills or Other Qualifications
Required: Must possess strong knowledge in hospital scheduling, registration, and insurance verification processes. Leadership and motivational skills. Strong written and verbal communication skills. Ability to supervise, organize, and facilitate multiple tasks and achieve results thru others. Strong interpersonal communication skills. Possess knowledge of insurance medical necessity policies and guidelines.
Preferred: Possess thorough knowledge of all phases of the insurance verification and authorization guidelines for hospital In Patient, Surgeries, and OP services (including insurance requirements and guidelines, ICD9/10 and CPT-4 coding. Knowledge and understanding of patients benefits, plan coverage, and claim responsibility.



About Hoag Memorial Hospital Presbyterian

Located on the bayside bluffs overlooking Newport Beach, Hoag Memorial Hospital Presbyterian stands atop the list of the finest medical facilities in Southern California. Fully accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and designated as a Magnet hospital by the American Nurses Credentialing Center (ANCC), Hoag Memorial Hospital Presbyterian is a 511-bed acute care, not-for-profit hospital that provides a quality work environment and quality lifestyle. This unique combination provides an enriching environment like no other.

A quality work environment and quality lifestyle enables our nurses to chart a satisfying course for every area of their lives - professional, family, friends and personal pursuits. Along with Hoag's commitment and family-oriented approach to providing the highest quality patient care, there is an indisputable pride in the way we fulfill our healing mission.

We invite you to be a part of the dynamic and rewarding career opportunities available at our top-rated medical facility, while enjoying the added luxury of the renowned Southern California lifestyle.

Take a look inside and we believe you'll see why there is no place like Hoag.

View available openings at Hoag Memorial Hospital Presbyterian


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About Hoag Memorial Hospital Presbyterian

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Learn more about Hoag Memorial Hospital Presbyterian

Learn more about Hoag Memorial Hospital Presbyterian