Insurance Authorization Specialist

EEO Statement Balboa United • San Diego, CA

7d • Hybrid

About The Position

The Insurance Authorization Specialist ensures accurate insurance registration, verification of coverage and eligibility, and timely acquisition of appropriate authorizations. The role helps ensure smooth patient check-in and that claims are processed and paid as authorized by completing insurance work before appointments and following up with payors, internal teams, and patients. The position works from the business office on Hazard Way in San Diego, California, and may be eligible for a hybrid schedule after successful completion of training. Travel to other sites within San Diego County may be required. There are no supervisory duties.

Balboa Nephrology is a kidney-care practice participating in a national Medicare value-based care program. The organization describes itself as growing and offers opportunities for professional and personal growth. Its mission is to consistently deliver superior care—Balboa Care—to every patient with kidney disease, guided by patient-centeredness, accountability, respect, innovation, and data-driven practices.

The position requires regular communication in English and understanding written and spoken clinical or medical vocabulary. Work routinely carries potential for contact with blood, body fluids, tissues, or spills and splashes, requiring appropriate personal protective measures. The role uses standard office equipment and has specified physical requirements, including lifting, standing, movement, and stair use.

Requirements

• At least 1 year of recent experience performing insurance registration, coverage and eligibility verification, and authorization work in a medical environment, or recent completion of a medical billing program with equivalent experience.
• Understanding of the revenue cycle process.
• Understanding of different coverages and payors, including Independent Practice Associations (IPAs), and the authorization process.
• Strong proficiency with Microsoft Windows, including navigating, creating and renaming folders, and saving and organizing files.
• Strong proficiency with Microsoft Office products, including Outlook, OneNote, Teams, Excel, and Word.
• Proficiency with Adobe PDF.
• Typing speed of at least 30 words per minute.
• A dedicated HIPAA-compliant, ergonomic workspace for remote work, with high-speed internet meeting minimum speed requirements.
• High school graduate or equivalent.
• Excellent verbal and written communication skills.
• Ability to provide excellent customer service.
• Ability to interpret, adapt, and apply guidelines and procedures.
• Ability to use sound reasoning and judgment and react appropriately in emergency situations.
• Ability to establish and maintain effective working relationships with patients, medical staff, and coworkers.
• Ability to multitask, stay organized, pay attention to detail, and prioritize work.
• Ability to talk, hear, read, write, type, and respond in English, and understand clinical or medical vocabulary in written and spoken form.
• Close vision, ability to adjust focus, and ability to see color.
• Ability to lift up to 35 pounds unassisted; stand for extended periods; perform repetitive stooping, walking, stretching, reaching, and some sitting; and use a full range of body motions to lift patients, wear a lead apron, and move supplies.
• Ability to safely ascend and descend stairs as a core part of the job, with or without reasonable accommodation, when no elevator or lift is present.
• Pass a background check.

Nice To Haves

• Three years of recent experience performing insurance registration, coverage and eligibility verification, and authorization work in a medical practice environment.
• Epic EHR experience.
• Bilingual in Spanish.
• Nephrology experience.

Responsibilities

• Complete insurance registration, coverage and eligibility verification, and authorization requests in a timely and appropriate manner, following payer and internal procedures with minimal supervision.
• Update registration and coverage at the account and visit levels as needed to prevent denials.
• Update copays for non-RTE payors and escalate incorrect RTE copays to leadership.
• Contact patients to obtain updated insurance information.
• Respond promptly and accurately to inquiries from patients, payers, and internal customers.
• Identify issues and trends affecting patient care, quality, and timely reimbursement, and report them to leadership with potential solutions.
• Meet quality and productivity standards.
• Support and participate in process-improvement initiatives.
• Perform other duties supporting the revenue cycle process and Balboa’s core values as assigned.

Benefits

• Medical, dental, and vision benefits beginning on the first of the month 30 days after hire.
• Employer 401(k) contribution of up to 7.5% of annual pay.
• Generous paid time off.
• Eight paid holidays.
• Birthday float day off.
• Mental health day.
• Company-paid life insurance.
• Eligible for a revenue cycle bonus incentive.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED