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AmeriPharma
Insurance Coordinator l
Career Insights for Eligibility Specialist
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Scorecard
Based on California data
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What they do
An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.
$54,990 / year median in California
+4% projected growth
Job Description
Insurance Coordinator l AmeriPharma - 2.7 Laguna Hills, CA Job Details Full-time $25 - $30 an hour 17 hours ago Benefits Health insurance Dental insurance Paid time off Employee assistance program Vision insurance Opportunities for advancement Qualifications Microsoft Excel Microsoft Outlook Medicare Managed care Writing skills Word embeddings English Medicaid health insurance ICD-10 Medicaid Typing Cross-functional collaboration Medical terminology Quality data entry Full Job Description About AmeriPharma AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves. AmeriPharma's Benefits Full benefits package including medical, dental, vision, life that fits your lifestyle and goals Great pay and general compensation structures Employee assistance program to assist with mental health, legal questions, financial counseling etc. Comprehensive PTO and sick leave options 401k program Plenty of opportunities for growth and advancement Company sponsored outings and team-building events Casual Fridays Job Summary As an Insurance Coordinator at AmeriPharma, you will be responsible for accurately and efficiently verifying patients' medical insurance coverage and obtaining required prior authorizations. This role helps ensure timely access to care while supporting appropriate reimbursement for services. You will work closely with insurance providers, patients, and internal teams to facilitate the authorization process, resolve coverage-related issues, and maintain accurate documentation to support prompt and compliant payment. Duties and Responsibilities Review and prioritize incoming orders requiring benefits investigation and medical prior authorization to ensure timely processing. Verify that patient insurance information is accurate, complete, and up to date within patient profiles. Contact insurance carriers to verify eligibility and benefits, including plan type, coverage limits, deductibles, exclusions, authorization requirements, and covered services. Accurately document all interactions with insurance representatives, including representative names, reference numbers, call details, and outcomes. Communicate insurance restrictions, coverage limitations, prior authorization requirements, and reimbursement concerns to the appropriate internal team members to support continuity of care and timely service. Perform additional duties and provide cross-functional support within the department as needed or as assigned by management. Promote a culture of accountability, integrity, collaboration, and service excellence while contributing to a positive and team-oriented work environment. Required Qualifications Proficient in English, including reading, writing, and verbal communication. Strong collaboration and interpersonal skills, with the ability to work effectively with team members and management. Excellent time management, organizational, and communication skills. High attention to detail with accurate data entry and minimal typing errors. Ability to work independently, prioritize tasks, and consistently meet deadlines in a fast-paced environment. Working knowledge of medical terminology, including ICD-10, CPT, and HCPCS coding. Familiarity with managed care, commercial insurance, Medicare, Medicaid, and insurance reimbursement processes. Proficient in Microsoft Word and Excel. Strong analytical and problem-solving skills with the ability to interpret insurance and reimbursement data effectively. Preferred Qualifications Experience in medical billing, coding, or insurance verification, with a strong understanding of managed care, commercial insurance, Medicare, and Medicaid reimbursement. Working knowledge of medical terminology, ICD-10, CPT, HCPCS, and J-codes, as well as