Insurance Coordinator

Harbor Community Clinic•Los Angeles, CA

68d•$23 - $26•Onsite

About The Position

Reporting to the Revenue Cycle Manager (RCM), the Insurance Coordinator plays a critical role in ensuring smooth and timely access to HarborCHC services by managing patient insurance verification and eligibility. Working closely with front office, enrollment, and billing staff, the Insurance Coordinator is responsible for verifying insurance benefits and eligibility for scheduled patients, troubleshooting issues, and educating patients and staff on public and private insurance programs. This role requires a keen attention to detail, strong communication skills, and a thorough understanding of insurance policies and procedures.

Requirements

High school diploma or equivalent required
Minimum of four (4) years of experience in insurance verification and medical billing in a healthcare setting is required.
Bilingual in English and Spanish required.
Must demonstrate good attendance and punctuality and complete all assignments timely.
Strong knowledge of Medi-Cal, Medicare, Family PACT, CPE, PE4PP, Covered California and Sliding Fee Scale programs.
Proficiency in medical terminology, billing codes, and insurance procedures.
Proficiency in using EHR and practice management software, eClinicalWorks a plus.
Proficient in the use of Microsoft Office programs (Outlook, Word, Excel, PowerPoint)
Excellent communication and interpersonal skills, with the ability to explain complex insurance information to patients.
Strong problem-solving and multitasking abilities.
Ability to handle sensitive and confidential information with discretion.

Nice To Haves

Associate’s or Bachelor’s degree in a related field preferred.
Prior work experience at a federally qualified health center (FQHC) preferred.

Responsibilities

Verify patient insurance coverage prior to appointments by contacting insurance companies and/or utilizing electronic verification tools to ensure correct benefits are in place for services to be rendered.
Review and interpret insurance policy documents to determine patient eligibility and benefit details.
Work with patients to gather insurance information and update records as needed.
Confirm eligibility for Medicaid, Medicare, private, and other insurance plans.
Investigate and resolve insurance-related issues, such as out-of-network, non-coverage of services, etc.
Serve as the liaison between the patient, the healthcare provider, and the insurance company to resolve issues in a timely manner.
Identify and address gaps in coverage and connect patients with an enrollment specialist if needed.
Communicate with patients to explain insurance benefits, coverage limitations, and out-of-pocket costs.
Address patient inquiries related to insurance benefits and resolve any issues or concerns.
Educate patients on co-pays, deductibles, and other out-of-pocket costs.
Maintain up-to-date records of insurance verification and authorizations in electronic health record (EHR) system.
Document all interactions and verification details in EHR for future reference and audit purposes.
Ensure timely follow-up on pending insurance verifications.
Collaborate with billing staff to ensure accurate submission of claims.
Work closely with billing department, front office staff, and enrollment specialists to streamline the insurance verification process.
Serve as the primary point of contact for insurance-related inquiries from staff; provide training and support to staff on insurance-related topics and procedures.
Participate in training and professional development opportunities to maintain up-to-date knowledge.
Provide feedback and recommendations for process improvements based on findings.
Ensure compliance with FQHC and insurance regulations, maintaining a high level of accuracy and patient confidentiality.