Top 104 Insurance specialist Jobs in Orange County Ca

Medical Insurance Authorization Specialist
National Healthcare and Housing Advisors, LLC —Santa Ana, CA
- $73,000 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Sales
Quick Apply
10d
Insurance Eligibility Specialist
Memorial Health Services —Fountain Valley, CA
- $22.89 - $33.18 an hour
- 8 hour shift
- Spanish
- Hospital
- HIPAA
- Health insurance
Insurance Verification Specialist: Patient Accounting
Hoag Health System —Costa Mesa, CA
- Full-time
- Mid-level
- Windows
- High school diploma or GED
Insurance Verification Specialist III: Cancer Outpatient Treatment Center
Hoag Health System —Irvine, CA
- Mid-level
- Windows
- High school diploma or GED
- Health insurance
Property Claims Specialist Field II - CAT/Spikes Team
Mercury Insurance Services, LLC —Brea, CA
- $76,829 - $142,213 a year
- Extended hours
- Bilingual
- Military
- Writing skills
- Paid holidays
- Health insurance
Claims Specialist
Liberty Mutual —Orange, CA
- $57,000 - $101,000 a year
- Full-time
- Customer service
- Mid-level
- Bachelor's degree
10d
Homeowners Insurance Specialist
Freeway Insurance Services America, LLC —Orange, CA
- $31 - $72 an hour
- Full-time
- Spanish
- English
- Mid-level
- Paid training
- Health insurance
Quick Apply
Workers' Compensation Claim Specialist
CCMSI —Irvine, CA
- $85,000 - $95,000 a year
- Remote
- Spanish
- Mid-level
- Analysis skills
- Paid holidays
- Disability insurance
Medical Insurance Verification Specialist
Caring Cardiology Medical Group —Laguna Hills, CA
- $19 - $25 an hour
- Full-time
- Microsoft Outlook
- Writing skills
- English
- Health insurance
- Flexible schedule
Quick Apply
Insurance Follow Up Specialist
PREMIER MEDICAL TRANSPORT INC —Costa Mesa, CA
- $20.00 - $27.50 an hour
- Full-time
- Microsoft Outlook
- Writing skills
- Research
- Health insurance
- Dental insurance
Quick Apply
Financial Professional
New York Life Insurance Company —Irvine, CA
- $50,000 - $125,000 a year
- Full-time
- Hybrid work
- Background check
- Sales
- Customer service
- Disability insurance
- Health insurance
Quick Apply
Financial Services Professional - Hybrid Remote (CA)
Bankers Life —Irvine, CA
- $70,000 - $100,000 a year
- Full-time
- Hybrid work
- Office
- Communication skills
- Entry level
Quick Apply
Acquisition Specialist - State Farm Agent Team Member
Poonam Walia - State Farm Agent —Riverside, CA
- $55,000 - $80,000 a year
- Full-time
- Mid-level
- Typing
- 1 year
- Paid holidays
- Tuition reimbursement
Quick Apply
Financial Services Professional
American Legacy Solutions —West Covina, CA
- $70,000 - $200,000 a year
- Full-time
- Bilingual
- Background check
- HIPAA
Quick Apply
Financial Professional
New York Life Orange Coast General Office Irvine —Irvine, CA
- $70,000 - $250,000 a year
- Full-time
- Hybrid work
- Background check
- Mid-level
- US work authorization
- Disability insurance
- Health insurance
Quick Apply
Financial Professional (Life Insurance Sales Agent)
New York Life Insurance Company —Corona, CA
- $38,650.30 - $158,639.29 a year
- Full-time
- Hybrid work
- Entry level
- Health insurance
- Dental insurance
Quick Apply
10d
Underwriting Specialist OR Executive Underwriter - Middle Market
Zurich Insurance Company Ltd. —Irvine, CA
- $87,200 - $188,700 a year
- Full-time
- Hybrid work
- Mid-level
- High school diploma or GED
- 1 year
SEO/ GEO Specialist
Adriana's Insurance —Irvine, CA
- From $70,304 a year
- Full-time
- Spanish
- English
- Office
- Health insurance
- Dental insurance
Quick Apply
Experienced Business Development Professional
The Fadil Group —Irvine, CA
- $150,000 - $171,000 a year
- Full-time
- Hybrid work
- Mid-level
- Business development experience
- Bachelor's degree
- Profit sharing
- Health insurance
Quick Apply
12d
Consumer Loan Professional
Mariner Finance —Santa Ana, CA
- $18.44 - $23.97 an hour
- Full-time
- Spanish
- English
- Office
Quick Apply

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Medical Insurance Authorization Specialist

National Healthcare and Housing Advisors, LLC
Santa Ana, CA

Quick Apply

Job Details

Full-time
$73,000 a year
10 days ago

Qualifications

Health insurance authorizations
Microsoft Excel
Microsoft Outlook
Overseeing health insurance pre-certification
Medicare
Electronic health records (EHR) management
Phone communication
Medical insurance coverage verification
Phone call backs
Managed care organization experience
Spreadsheets
Maintaining patient confidentiality
HIPAA
High school diploma or GED
Client follow-up
Patient portals
Health information regulatory compliance
Medicaid
Managing patient records
Client interaction via phone calls

Full Job Description

The Authorizations Specialist is responsible for managing authorizations across multiple Medi-Cal managed care plans, monitoring authorization status, and ensuring timely reimbursement for services rendered. This role supports the revenue cycle by resolving authorization, eligibility, and admission-related discrepancies; reducing outstanding and aging authorizations; and escalating complex issues as needed. The ideal candidate is highly detail-oriented, organized, and persistent in follow-up efforts, with proficiency in health plan portals, electronic health record (EHR) systems, and Microsoft Excel. Strong communication skills and the ability to conduct consistent follow-up with health plans, providers, and stakeholders via phone and email are essential to success in this role.

Key Responsibilities

Submit, track, and manage authorization requests with Medi-Cal managed care plans and other payer sources to ensure timely approval of services.
Verify client eligibility, benefits, and authorization requirements prior to admission and service delivery.
Monitor authorization status through health plan portals, phone outreach, fax, and email correspondence; identify and resolve delays in processing.
Maintain accurate authorization records within the electronic health record (EHR), payer portals, spreadsheets, and internal tracking systems.
Review authorization aging reports and proactively work pending, expired, modified, denied, or unresolved authorizations to secure approval and reimbursement.
Contact health plans, payors, and utilization management departments to verify authorization status and address barriers to approval.
Research and resolve authorization denials, discrepancies, and documentation deficiencies by coordinating with clinical, admissions, billing, and care coordination teams.
Prepare and submit reconsiderations, retroactive authorization requests, and appeals with supporting documentation within required timelines.
Review service dates, approved units, levels of care, and authorization utilization to ensure services are accurately covered and documented.
Identify trends contributing to authorization delays, denials, or reimbursement issues and communicate findings to leadership.
Document all authorization activities, follow-up efforts, and payer communications thoroughly and accurately.
Collaborate with admissions, billing, coding, and program staff to resolve authorization-related discrepancies and support revenue cycle operations.
Escalate complex, high-dollar, compliance-related, or unresolved authorization issues to management as appropriate.
Assist with reimbursement reconciliation by identifying authorization-related variances between approved services and payments received.
Generate and maintain reports related to authorization status, aging authorizations, denials, approvals, and reimbursement trends.
Maintain compliance with HIPAA, payer requirements, contractual obligations, and organizational policies and procedures.
Assist with audits, record reviews, and documentation requests related to authorizations and reimbursement.
Identify opportunities to improve authorization workflows, reduce processing delays, and enhance operational efficiency.
Perform other duties as assigned in support of authorization management and revenue cycle operations.

Positions Requirements & Qualifications

Required Qualifications

High school diploma or equivalent required; Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, Public Health, or a related field preferred.
Minimum of two (2) years of experience in healthcare authorizations, utilization management, medical billing, revenue cycle, or a related healthcare administrative role.
Experience working with Medi-Cal managed care plans, health insurance payors, and authorization processes.
Proficiency with electronic health record (EHR) systems, payer portals, Microsoft Excel, and other healthcare software applications.
Strong knowledge of insurance eligibility verification, authorization requirements, reimbursement processes, and healthcare documentation standards.
Excellent organizational skills with the ability to manage multiple priorities, deadlines, and high-volume workloads.
Strong analytical and problem-solving skills with attention to detail and accuracy.
Effective verbal and written communication skills, including the ability to communicate professionally with health plans, providers, and internal stakeholders.
Ability to work independently, exercise sound judgment, and maintain confidentiality.
Knowledge of HIPAA regulations and healthcare compliance requirements.

Preferred Qualifications

Experience in recuperative care, care management, behavioral health, homeless services, or community-based healthcare programs.
Familiarity with Community Supports, or Medi-Cal managed care plan operations.
Experience preparing authorization appeals, retroactive authorization requests, and payer escalations.
Working knowledge of revenue cycle management and reimbursement processes.

Additional Preferred Skills

Sales, account management, customer service, or business development experience strongly preferred, with the ability to build relationships, conduct persistent follow-up, navigate challenging conversations, and effectively advocate with health plans and external partners.
Demonstrated ability to negotiate, influence outcomes, and maintain professional relationships while working toward authorization approvals and issue resolution.

Pay: $73,000.00 per year

Work Location: In person

Quick Apply

Refine Your Search

insurance specialist jobs in orange county ca

Medical Insurance Authorization Specialist

Insurance Eligibility Specialist

Insurance Verification Specialist: Patient Accounting

Insurance Verification Specialist III: Cancer Outpatient Treatment Center

Property Claims Specialist Field II - CAT/Spikes Team

Claims Specialist

Homeowners Insurance Specialist

Workers' Compensation Claim Specialist

Medical Insurance Verification Specialist

Insurance Follow Up Specialist

Financial Professional

Financial Services Professional - Hybrid Remote (CA)

Acquisition Specialist - State Farm Agent Team Member

Financial Services Professional

Financial Professional

Financial Professional (Life Insurance Sales Agent)

Underwriting Specialist OR Executive Underwriter - Middle Market

SEO/ GEO Specialist

Experienced Business Development Professional

Consumer Loan Professional

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