Bayside Surgery Center is a AAAHC-accredited outpatient ambulatory surgery center specializing in interventional pain management procedures. The center performs minimally invasive pain management procedures such as cervical and lumbar neurostimulator trials and permanent implants, epidural steroid injections, medial branch blocks, trigger point injections, and other image-guided interventional procedures.
The Insurance Specialist role requires onsite presence Monday through Friday, 9AM-5PM. Responsibilities include obtaining and verifying insurance eligibility, coordinating benefits, collecting payments, managing insurance intake, claims follow-up, denials, appeals, and coordinating denial management and appeals with insurance companies and physician offices. The specialist will maintain accurate documentation related to billing, claims, appeals, and collections, and provide insurance companies with required clinical information such as laboratory results, diagnosis codes, ICD-10 codes, operative notes, and supporting medical documentation.
The role requires interaction with physicians, clinical staff, patients, and families, maintaining professionalism and confidentiality, compliance with HIPAA and AAAHC standards, and adherence to infection control policies. Additional duties support the surgery center's operations as assigned.
Minimum of 5 years of experience in financial intake or insurance capacity within a healthcare provider setting is required. Candidate must have experience in medical insurance verification, prior authorizations, medical billing, revenue cycle management, or healthcare administration. Prior experience in an ambulatory surgery center, pain management, surgical specialty, or outpatient clinical setting is preferred.
Requires working knowledge of commercial insurance plans, Medicare, coordination of benefits, claims processing, denials, and appeals. Experience obtaining prior authorizations, handling CPT codes, ICD-10 coding, medical terminology, payer guidelines, patient financial counseling, self-pay estimates, payment collections, and arrangements is desired.
Proficiency with EMR, billing software, and insurance portals is required. The candidate must demonstrate exceptional organizational, communication skills, professionalism, critical thinking, attention to detail, ability to work independently in a fast-paced healthcare environment, and strict confidentiality in compliance with HIPAA.
Location
California, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
2 weeks ago