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Insurance Coordinator
Job
Robert Half
San Jose, CA (In Person)
Full-Time
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Job Description
We are looking for an Insurance Coordinator to support insurance-related workflows for a service-focused team in San Jose, California. This Long-term Contract position is ideal for someone who is highly organized, detail-oriented, and experienced in reviewing coverage information to help ensure efficient coordination of services. The person in this role will work closely with patients, providers, and payers to confirm benefits, secure approvals, and maintain accurate documentation.
Responsibilities:
- Confirm active medical coverage and benefit details with insurance carriers before services are scheduled or delivered.
- Obtain required prior authorizations and referrals to prevent delays in service and support timely care coordination.
- Review payer guidelines and plan rules to determine eligibility, coverage limits, and out-of-pocket responsibilities.
- Communicate with internal teams, patients, and insurance representatives to resolve verification issues and missing information.
- Maintain complete and accurate records of insurance activity, authorization status, and follow-up actions in appropriate systems.
- Track pending approvals and proactively follow up with payers to ensure decisions are received within expected timeframes.
- Escalate complex coverage or authorization concerns when additional review or intervention is needed.