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Insurance Eligibility Verification Jobs in California

TARLANI Healthcare

Insurance Eligibility

Montrose, CA

$21 - $25/hr

Verify insurance eligibility; contact patients and departments with any negative outcomes * Assist billing with claims issues due to insurance authorization denials * Work closely with the clinical ...

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Insurance Eligibility Verification information

What is an insurance eligibility verification?

An Insurance Eligibility Verification job involves reviewing and confirming a patient's insurance coverage and benefits before medical services are provided. Responsibilities include contacting insurance companies, verifying policy details, checking co-pays, deductibles, and coverage limits, and updating patient records accordingly. This role helps prevent billing issues and ensures healthcare providers receive proper reimbursement. Strong attention to detail, communication skills, and knowledge of insurance policies are essential for success in this position.

What are the key skills and qualifications needed for insurance eligibility verification?

Strong attention to detail, knowledge of insurance policies and terminology, and experience in healthcare or insurance administration are core requirements for an Insurance Eligibility Verification role. Familiarity with insurance verification software, electronic health records (EHR) systems, and payor portals is often needed, while certifications such as Certified Revenue Cycle Representative (CRCR) can be beneficial. Exceptional communication, organizational skills, and the ability to problem-solve under time constraints will help someone excel in this position. Mastery of these skills ensures accurate benefit verification, timely patient care, and efficient interaction with both patients and insurance providers.

What are some typical challenges faced in an insurance eligibility verification role?

One common challenge in Insurance Eligibility Verification is navigating the complexities of various insurance plans and keeping up with frequent policy changes. The role often requires resolving discrepancies between patient information and insurance records, which can involve significant research and communication with both patients and insurers. Additionally, working under tight deadlines to confirm eligibility before scheduled procedures is a frequent aspect of the job. However, mastering these challenges can build valuable expertise and open up further advancement opportunities in healthcare administration or revenue cycle management.

What are popular job titles related to Insurance Eligibility Verification jobs in California?

For Insurance Eligibility Verification jobs in California, the most frequently searched job titles are:

What job categories do people searching Insurance Eligibility Verification jobs in California look for?

The top searched job categories for Insurance Eligibility Verification jobs in California are:

What cities in California are hiring for Insurance Eligibility Verification jobs?

Cities in California with the most Insurance Eligibility Verification job openings:

Insurance Eligibility Verification jobs near you
Infographic showing various Insurance Eligibility Verification job openings in California as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Insurance Eligibility

Alliance Health Services, Inc.

Montrose, CA

$21 - $25/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 23 days ago

Job description

Job Type: Full-time

Pay: From $21.00 - 25.00 per hour

Work Location: In person

Job Description

Alliance Health Services is dedicated to providing innovative, quality, and cost-effective home health services to patients in their homes involving families that require skilled nursing, rehabilitative, and support services.

Responsibilities

The position will entail the timely submission of authorization requests to assigned payers. Submission of requests will be completed using paper forms, printed documentation, fax, payer portals, or other means. Complete follow-up on requests to ensure timely turnaround and approval. Understand payer requirements to ensure approval is granted. Escalate problem accounts and ensure resolution. Regular contact with patients, insurance plans, physician offices, respiratory therapists, and other personnel is necessary.

Duties

  • Obtain authorization for patient care (initial authorization, reauthorization, follow-up on prior authorization, etc.)
  • Verify insurance eligibility; contact patients and departments with any negative outcomes
  • Assist billing with claims issues due to insurance authorization denials
  • Work closely with the clinical teams and referral sources regarding current and future authorization needs
  • Maintain progress/tracking reports on outstanding authorization to ensure timely request, receipt, and processing of authorization
  • Collect, review, discuss, and document demographic, insurance, and financial information with patients and payers
  • Follow approved guidelines and policies regarding routine patient and payer interactions
  • Negotiate payment reimbursement from a patient and third-party payers
  • Other duties as assigned

Benefits:

  • 401(k)
  • Health insurance
  • Dental
  • Vision
  • Holiday

Requirements:

  • Minimum of 1 year of experience in an insurance benefits coordinator role; preferably in a home health setting.
  • Communicate clearly and concisely, both orally and in writing, including the ability to follow a written script, submit comprehensive summary reports and other written materials.
  • Organize and maintain extensive records, research and compile information, and have the ability to multi-task in a fast-paced environment.
  • Strong technical aptitude to not only operate standard office equipment but also relevant software such as Microsoft Word, Excel, Outlook, EMR & Practice Management Systems and other applications.
  • Plan, organize, prioritize, and perform duties in accordance with department policy and procedure as assigned with minimal supervision.
  • Establish and maintain effective working relationships with our patients and all levels of staff
  • Minimum of 1 year of experience using EMR softwares
  • Medical billing: 1 year (Required)

Education:

High school or equivalent (Required)

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