Insurance Authorization Specialist

Balboa Nephrology • San Diego, CA

8d • $23 - $26 • Hybrid

About The Position

The Insurance Authorization Specialist ensures accurate insurance registration, verifies coverage and eligibility, and obtains appropriate authorizations. The role helps ensure patients have a smooth check-in by completing insurance tasks before appointments so claims can be processed and paid as authorized. This includes working assigned queues on time and following up with payers, internal teams, and patients.

The position works out of the business office on Hazard Way in San Diego, California. A hybrid schedule may be available after successful completion of training. The listed pay range is $23–$26 per hour, based on experience, with eligibility for a revenue cycle bonus incentive. This position has no supervisory duties. Travel to other sites within San Diego County may be required.

The work involves routine potential exposure to blood, body fluids, tissues, and spills or splashes; appropriate personal protective measures are required. Routine office equipment includes a laptop, computer, mouse, and photocopier. The role requires communication and written comprehension in English, including clinical and medical vocabulary.

Requirements

• At least 1 year of recent experience performing insurance registration, coverage and eligibility verification, and obtaining authorizations in a medical environment, or recent completion of a medical billing program and equivalent experience.
• Understanding of the revenue cycle process, different coverage types and payers (including Independent Practice Associations), and authorization processes.
• 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.
• Ability to type 30 words per minute.
• Dedicated HIPAA-compliant, ergonomic workspace suitable for uninterrupted 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 written and spoken clinical or medical vocabulary.
• Ability to lift up to 35 pounds unassisted; stand for extended periods; perform repetitive stooping, walking, stretching, reaching, and some sitting; use the full range of body motions needed to lift patients, wear a lead apron, and move supplies; and safely ascend and descend stairs, with or without reasonable accommodation, when no elevator or lift is present.
• Successful completion of a background check.

Nice To Haves

• At least 3 years of recent experience performing insurance registration, coverage and eligibility verification, and obtaining authorizations in a medical practice environment.
• Epic EHR experience.
• Bilingual in Spanish.
• Nephrology experience.

Responsibilities

• Complete timely and appropriate insurance registration, coverage and eligibility verification, and authorization tasks according to payer and internal procedures, with minimal supervision.
• Update insurance registration and coverage at the account and visit levels as needed to prevent denials.
• Update copays for non-RTE payers 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; report them to leadership with potential solutions.
• Meet quality and productivity standards.
• Support and participate in process improvement initiatives.
• Assist with other duties supporting the revenue cycle process and Balboa’s core values, as assigned.

Benefits

• Medical, dental, and vision coverage beginning on the first of the month 30 days after hire.
• Employer contribution of up to 7.5% of annual pay to a 401(k).
• Paid time off, 8 paid holidays, a birthday float day off, and a mental health day.
• Company-paid life insurance.
• Eligibility for a revenue cycle bonus incentive.

What This Job Offers

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