Insurance Verifier

A healthcare company is looking for an Insurance Verifier to support pre-service financial clearance for surgical patients in California. This Insurance Verifier focuses on confirming coverage details, identifying authorization needs, and helping patients understand their expected financial responsibility before scheduled procedures. The Insurance Verifier will work closely with clinical, scheduling, and revenue cycle teams to reduce avoidable claim issues and keep cases on track for timely treatment.

Key Responsibilities:

• Conduct pre-procedure insurance reviews to confirm active coverage and validate plan benefits for scheduled surgical services.

• Assess deductibles, copayments, coinsurance amounts, out-of-pocket limits, and any exclusions that may affect patient liability.

• Determine when prior authorization or referral approval is required and record all supporting details for follow-up by the appropriate teams.

• Examine scheduled services and provider documentation to ensure payer rules and coverage criteria are satisfied before the surgery date.

• Prepare clear cost estimates for patients and explain expected financial obligations with professionalism and empathy.

• Enter complete and accurate verification findings into the electronic medical record and related practice management tools.

• Partner with scheduling, admissions, clinical, and billing personnel to resolve benefit discrepancies or missing information ahead of treatment.

• Escalate potential coverage concerns quickly so patients and care teams can address issues before delays or cancellations occur.

• Maintain thorough records of payer communications, verification activity, and authorization status while following applicable compliance standards.

Benefits: Health, Dental, Vision, 401k, and Sick Time Off.

TalentMatch^®

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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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Qualifications

Qualifications:

• • Previous experience in insurance verification, patient access, claims support, or a similar healthcare revenue cycle function
• • Working knowledge of commercial health plans, Medicare, Medicaid, and managed care benefit structures
• • Ability to interpret eligibility responses, benefit details, authorization requirements, and medical necessity guidelines
• • Strong computer skills with experience documenting information accurately in healthcare software systems
• • Clear communication skills for discussing financial responsibility with patients and coordinating with internal teams
• • High attention to detail and strong organizational ability when tracking multiple cases and deadlines
• • Background in a surgery center, hospital, physician office, or comparable clinical setting is preferred

Work for Warriors is a no-cost employment program of the California Military Department for Service Members, Veterans, and military family members. The Veteran Staffing Consultant for Robert Half is Tracey Huerta.