Top 13 Insurance verification specialist Jobs in Citrus Heights Ca

Medical Insurance Authorization and Billing Specialist
A Senior Connection —Sacramento County, CA
- $55,000 - $80,000 a year
- Full-time
- Hybrid work
- Background check
- Google Workspace
- HIPAA
- Health insurance
- 401(k)
Quick Apply
8d
Insurance Verification Specialist
Shriners Hospitals for Children —Sacramento, CA
- $29.16 - $41.16 an hour
- 18 years or older
- Microsoft Excel
- Microsoft Outlook
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5d
Insurance Verification Specialist
Straine Dental Management LLC —Rocklin, CA
- From $28 an hour
- Part-time
- Dental office
- HIPAA
- Organizational skills
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Patient Services Representative 3
UC Davis Health —Sacramento, CA
- $31.24 - $38.84 an hour
- Overtime
- Background check
- Word processing
- Writing skills
- Continuing education credits
- Paid holidays
5h
Office Specialist Level I/II
Sacramento County, CA —Sacramento, CA
- $46,061.28 - $62,953.20 a year
- Online Application
- Writing skills
- Basic math
- No experience needed
- Health savings account
- Disability insurance
Patient Access Representative Full Time
West Coast Joint and Spine (13106) —El Dorado Hills, CA
- $25 an hour
- Full-time
- HIPAA
- Typing
- Outpatient
- Health savings account
- AD&D insurance
Referral Coordinator
SACRAMENTO NATIVE AMERICAN HEALTH CENTER INC —Sacramento, CA
- $22 - $24 an hour
- Computer literacy
- Writing skills
- HIPAA
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2d
Medical Front Office - Patient Service Specialist
Select Physical Therapy —Sacramento, CA
- $23 - $25 an hour
- Full-time
- Spanish
- Physical & Rehabilitation Medicine
- English
- Health insurance
- Dental insurance
9d
Business Banking Support Specialist
U.S. Bank National Association —Sacramento, CA
- $25.77 - $34.33 an hour
- Full-time
- Hybrid work
- Mid-level
- Office
- 3 years
- Paid holidays
- Disability insurance
8d
Medical Biller, Coder, and Credentialing Specialist
Verity MD —Folsom, CA
- $22 - $30 an hour
- Part-time
- Mid-level
- Administrative experience
- Clinic
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Credentialing, Privileging & Enrollment Supervisor
WellSpace Health —Sacramento, CA
- $95,680 - $108,500 a year
- Full-time
- Anatomy knowledge
- 5 years
- Word processing
- Paid jury duty
- AD&D insurance
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Receptionist, Dental
Shingle Springs Band of Miwok Indians —Placerville, CA
- $20.85 - $26.50 an hour
- Full-time
- Dental office
- Current TB test
- BLS Certification
- On-the-job training
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Medical Insurance Authorization and Billing Specialist
A Senior Connection —Sacramento County, CA
Associate degree; bachelor’s preferred - or equivalent work experience. Use internal tracking tools consistently and keep documentation systems updated.
$55,000 - $80,000 a year
Quick Apply
8d
Insurance Verification Specialist
Shriners Hospitals for Children —Sacramento, CA
Responsible for checking insurance eligibility. Review information for admission including type and duration of service, authorization and treatment codes.
$29.16 - $41.16 an hour
Quick Apply
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Medical Insurance Authorization and Billing Specialist

A Senior Connection -
Sacramento County, CA

Quick Apply

Job Details

Full-time
$55,000 - $80,000 a year
8 days ago

Benefits

Health insurance
401(k)
Paid time off
401(k) matching

Qualifications

Teamwork
Overseeing health insurance pre-certification
Medicare
HIPAA
Filing
Records management
Medical claims submission

Full Job Description

Agency: A Senior Connection

Job Title: Medical Insurance Authorization and Billing Specialist

Reports to: Program Supervisor or Program Director

Works in Collaboration With: CEO, Program Director, Program Supervisor, Lead Care Managers, Navigators, Intake staff, Billing & Ops Assistant

Location: This is hybrid position. You will be required to have a HIPAA complaint at home office and meet (at minimum quarterly) in Sacramento and surrounding counties. While the position is hybrid, you must be located in Northern California. Those who do not reside in the surrounding areas will not be considered.

*This position requires experience in medical authorizations and billing. Additionally, priority will also go to applicants with experience in claims and denials. If you do not have experience in both medical (health insurance) authorizations and billing, please do not apply.

Position Summary

The Medical Insurance Authorization and Billing Specialist oversees all authorization and documentation workflows related to CalAIM Enhanced Care Management (ECM) and Community Supports (CS) services. This role is responsible for ensuring timely submission of all required documentation to managed care plans (MCPs), supporting intake, eligibility processes, and service-type determinations, and maintaining compliance with all regulatory and contractual documentation standards. The Medical Insurance Authorization and Billing Specialist also assists with and/or oversees all MCP-required reporting including client status lists and provider capacity reports. The Medical Insurance Authorization and Billing Specialist plays a critical role in ensuring that services are approved and delivered in alignment with contractual expectations and billing requirements.

Essential Job Duties and Responsibilities: Authorizations & Submissions

Manage all member service authorizations and billing (initial and reauthorizations) for active ECM and CS participants
Prepare and submit required forms to MCPs (e.g., MIFs, Capacity Reports, OTF/RTF, close loop referrals)
Ensure timeliness and accuracy of authorizations and billing to avoid service or payment delays
Maintain up-to-date knowledge of authorization and billing protocols across different MCPs
Flag and track authorization denials, claims, billing, preparing and submitting necessary appeals and grievances and monitoring and escalating trends to leadership

Documentation Oversight

Track all submitted documentation and ensure proper filing within EMR and relevant systems
Keep collections reports updated with status changes and new authorizations
Conduct internal checks for completeness of documentation (e.g., assessments, consent forms)
Collaborate with billing and leadership to align authorization and documentation processes
Flag and escalate any eligibility or documentation gaps that may impact services

Eligibility & Intake Support

Participate in or support real-time eligibility verification for new referrals and members
Coordinate with intake staff to ensure proper documentation is received and processed for new members
Work directly with referral partners, clients, or responsible parties during the eligibility and authorization process, communicating statuses and requesting necessary documentation or forms as required
Provide timely warm-hand-offs to LCM once member is authorized and notify all required team members (Program Supervisor or Director, Claims, etc.)

Program Compliance

Stay current on CalAIM ECM/CS documentation requirements and MCP updates, helping to communicate updates to the rest of the staff.
Support leadership in preparing for audits or reporting by ensuring clean, complete records
Closely monitor authorizations and expiration dates to ensure ongoing service continuity
Cross-reference billing tracker to help ensure service encounters align with approved services
Work directly with MCP to manage authorization barriers, communicate regarding MCP-required reporting, and respond to client service questions
Develop or improve upon workflows and train staff to ensure they are aligned with items that impact authorization and MCP requirements

General Expectations

Demonstrate accuracy, timeliness, and organization in documentation workflows
Be proactive in identifying documentation issues or inefficiencies and suggesting improvements
Manage time effectively, prioritize competing demands, and meet multiple deadlines with accuracy
Communicate clearly and professionally with care teams, MCPs, and leadership around documentation needs
Protect member privacy and comply with HIPAA at all times
Use internal tracking tools consistently and keep documentation systems updated
Collaborate respectfully across all departments and regions
Demonstrate initiative and flexibility when navigating changes in MCP or CalAIM protocols, and the ability to work independently with minimal supervision
Participate in staff meetings and trainings as assigned
Represent ASC professionally and in alignment with its mission and values

Qualifications

Associate degree; bachelor’s preferred - or equivalent work experience
Required minimum 2 years of experience in health care authorizations and billing with priority to those who have experience working with claims/denials
Proficiency with CalAIM, ECM, and MCP reporting, documenting, and authorization workflows highly preferred
Experience with EMRs and document management systems
Strong attention to detail and high level of accuracy
Knowledge of Kaiser, Anthem, Health Net, Partnership, Molina, and/or Healthplan of San Joaquin highly preferred
Proficiency in Google Workspace, SalesForce, or equivalent platforms

Work Setting

80% remote / home-office based
20% in-person for client in person outreach attempts, team collaboration, training, and file review as needed
This is a hybrid position

Position Growth & Flexible Support Responsibilities

This is a growing position. At the time of hire, the Medical Insurance Authorization and Billing Specialist role may not yet be full-time based solely on authorization-related duties, as authorization volume will continue to expand alongside program growth, service expansion, and additional MCP contracts. During this initial growth phase, the Medical Insurance Authorization Specialist may be asked to support additional operational or administrative tasks that reasonably align with this role and do not require extensive additional training. These duties are intended to complement authorization, documentation, and program support workflows and may include, but are not limited to:

Administrative support for ordering program or office supplies through approved online platforms
Light intake, referral coordination, or documentation support
Data tracking, reporting, or spreadsheet maintenance
Documentation cleanup or quality assurance reviews
Cross-team administrative support services
Optional support with accounts receivable–related tasks (for individuals with prior A/R or billing experience; not required)
Process improvement or workflow documentation projects

As authorization volume increases, the role is expected to evolve into a more fully dedicated authorization-focused position. ASC is committed to regularly evaluating workload, scope, and capacity to ensure responsibilities remain appropriate, sustainable, and aligned with program and funding needs. Flexibility, initiative, and a collaborative mindset are essential during this growth phase. This role offers the opportunity to contribute to operational support while helping build and refine authorization workflows as the program scales.

*Please answer the pre-screen questions to be considered for this role.

Job Type: Full-time

Pay: $55,000.00 - $80,000.00 per year

Benefits:

401(k)
401(k) matching
Health insurance
Paid time off

Application Question(s):

Briefly describe your hands-on medical insurance authorization experience, including how many years you’ve performed prior authorizations and the types of services you handled.
Which California Medi-Cal Managed Care Plans (MCP) have you worked with directly when submitting authorizations?
What specific experience do you have with medical insurance authorization or prior authorization workflows?
Which insurance verification or authorization systems/portals (payer portals/EHR) are you comfortable with?

Work Location: Hybrid remote in Sacramento County, CA

Quick Apply

Refine Your Search

insurance verification specialist jobs in citrus heights ca

Medical Insurance Authorization and Billing Specialist

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Insurance Verification Specialist

Patient Services Representative 3

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Referral Coordinator

Medical Front Office - Patient Service Specialist

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Medical Biller, Coder, and Credentialing Specialist

Credentialing, Privileging & Enrollment Supervisor

Receptionist, Dental

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