69,188 Health Insurance Specialist jobs in the United States

Description
Venice Family Clinic is a leader in providing comprehensive, high-quality health care to people in need. The organization has more than 500 staff who serve 45,000 people with compassion, dignity, and respect across an area from the Santa Monica Mountains through the South Bay. We have a network of clinics, Early Head Start centers, and mobile clinics, plus an expansive street medicine program to reach people experiencing homelessness. Read more about us at venicefamilyclinic.org.
Use your expertise to grow your career while making a difference in the communities we serve. With guidance and direction from the Health Insurance Program Manager, the Senior Health Insurance (HIE) Specialist will provide high quality screening/enrollment to patients and provide advocacy accessing and utilizing services. The Senior HIE Specialist will:
+ Determine the degree of case urgency and create an appropriate resolution plan.
+ Use their knowledge of current Public Health Insurance and other public benefit programs (e.g. Cal Fresh/SNAP) to respond to clients and outside agencies regarding Medi-cal, Covered CA, Cal Fresh, Kaiser CHCP and other health access concerns.
+ Provide expertise, guidance, coordination, and technical direction to staff and outside agencies on complex case inquiries in a timely manner and manage any urgent coverage needs for a rapid resolution.
+ Perform other duties as assigned by management.
Salary range: $30.36 - $43.49 Hourly
Qualifications
Required
+ Experience working with low-income, underserved families and children
+ Experience with Medi-Cal, Covered California, and other public benefits
+ Bilingual oral and written Spanish/English language skills
+ Strong verbal and written communication and active learning skills
+ Initiative, problem solving-solving skills, and time management skills
+ Desire to work with individuals from diverse ethnic, educational, and socioeconomic backgrounds
+ Interest in advocating to promote health care accessibility
+ Ability and willingness to travel to our other locations within LA County as needed (will be assigned to work at multiple sites).
+ Ability to learn complex policies and program rules of all the public health insurance programs.
UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person's unique achievements and experiences to further set us apart.

**16923BR**
**Title:**
Health Insurance & Authorization Specialist I
**Department/Cost Center:**
846 - Business Office/Cashiers
**Job Description:**
he Health Insurance and Authorization Specialist is responsible to assess and perform quality control function for all preadmission visits on surgical inpatient, short stay 23 (SS23), Endo and ambulatory procedures ensuring all pertinent information is on file and accurately documented. These activities include review diagnosis and history for correct insurance coverage, insurance eligibility and coverage verification using the three patient identifiers, confirming prior authorization is on file for correct level of care, inquires on prior auth denials and works with the Provider's office to resolve, requests estimated cost and collects deposits for non-covered services, ensures appropriate medical justification is documented for out-of-network payers, refers our self-pay patients to Financial Case Management (FCM) for Medicaid assessment or Financial Assistance, reviews and validates MSP questions, monitors Medicare days for exhausted benefits, identifies and resolves coordination of benefits discrepancies, and notifies Utilization Management of additional clinical requests
**Salary Range:**
$19.62 - $26.49 an hour
_The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._
**Auto req ID:**
16923BR
**Job Requirements:**
1. Education: High school Diploma or equivalent required. Associate degree preferred in related discipline (admitting/registration/patient billing/insurance); or equivalent experience
2. Experience: Minimum of 3 years of related experience preferably in a hospital setting, medical office billing and or knowledge of third-party insurance regulations.
3. Skills: Require high degree of professionalism and motivation with excellent communication and customer service skills, and medical terminology. Good interpersonal and telephone skills. Detail oriented. Computer, copier and FAX skills.
**Employment Status:**
Full-Time
**Hours/Week:**
40hrs
**Posting Title:**
Health Insurance & Authorization Specialist I
**City:**
Rochester
**Work Shift:**
Days
**Area of Interest:**
Clerical
The Hospital is committed to equal opportunity for all persons regardless of age, color, disability, ethnicity, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by law.

**16795BR**
**Title:**
Health Insurance & Authorization Specialist I
**Department/Cost Center:**
846 - Business Office/Cashiers
**Job Description:**
The Health Insurance and Authorization Specialist is responsible to assess and perform quality control function for all preadmission visits on surgical inpatient, short stay 23 (SS23), Endo and ambulatory procedures ensuring all pertinent information is on file and accurately documented. These activities include review diagnosis and history for correct insurance coverage, insurance eligibility and coverage verification using the three patient identifiers, confirming prior authorization is on file for correct level of care, inquires on prior auth denials and works with the Provider's office to resolve, requests estimated cost and collects deposits for non-covered services, ensures appropriate medical justification is documented for out-of-network payers, refers our self-pay patients to Financial Case Management (FCM) for Medicaid assessment or Financial Assistance, reviews and validates MSP questions, monitors Medicare days for exhausted benefits, identifies and resolves coordination of benefits discrepancies, and notifies Utilization Management of additional clinical requests
**Salary Range:**
$19.62 - $26.49 an hour
_The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._
**Auto req ID:**
16795BR
**Job Requirements:**
1. Education: High school Diploma or equivalent required. Associate degree preferred in related discipline (admitting/registration/patient billing/insurance); or equivalent experience
2. Experience: Minimum of 3 years of related experience preferably in a hospital setting, medical office billing and or knowledge of third-party insurance regulations.
3. Skills: Require high degree of professionalism and motivation with excellent communication and customer service skills, and medical terminology. Good interpersonal and telephone skills. Detail oriented. Computer, copier and FAX skills.
**Employment Status:**
Full-Time
**Hours/Week:**
40
**Posting Title:**
Health Insurance & Authorization Specialist I
**City:**
Rochester
**Work Shift:**
Days
**Area of Interest:**
Clerical
The Hospital is committed to equal opportunity for all persons regardless of age, color, disability, ethnicity, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by law.

At EMC, we're all about working together to make an impact. As part of our team, you'll have the opportunity to grow, contribute, and gain experience that matters. We strive to be caring leaders, close partners, and responsive experts-always supporting each other to do our best work. Join us, and let's improve lives together.

Essential Functions:

• Drives the complex product development effort within a dedicated team to create a product that generates desired benefits.
• Leads the generation and management of work to be completed by the development team.
• Optimizes the value of work performed by the team and ensures stakeholders understand the overall product strategy and product roadmap by maintaining and ensuring the product roadmap and product backlog are visible to all those involved with the product.
• Collaborates daily with the business and IT to refine, organize and prioritize requests in accordance with corporate strategies and goals.
• Creates and modifies the product vision, creates user stories and acceptance criteria, grooms the product backlog, plans releases and attends Scrum ceremonies.
• Coordinates all user acceptance testing (UAT) within each Sprint.
• Accepts the product increment by ensuring that the acceptance criteria of the story is met.
• Makes decisions that determine the profitability of the product (ROI).
• Ensures team is working on items that will deliver maximum value and are aligned with product vision.
• Provides input and guidance to the portfolio team on the current and future state of the product roadmap.
• Develops appropriately detailed specifications for product features and ensures they are clearly understood by the team.
• Motivates the team to deliver innovative solutions with an appropriate sense of urgency.
• Acts as an ambassador for the product internally and externally, and as the primary technical contact for queries related to the product.
• Works with key stakeholders across the company to ensure successful product releases.
• Maintains market awareness of third-party solutions to improve speed of delivery and efficiencies.
• Maintains third party relationships and evaluates vendor solutions for integration into EMC capabilities.
• Gathers and documents feedback from the users to improve their overall customer experience.

Education & Experience:

• Bachelor's degree or equivalent relevant experience
• Five years of experience in the field of IT projects, business analysis or equivalent subject matter expertise in applicable business field, including two years of experience as a product owner or similar role in the industry
• Experience in an Agile software development environment or related experience preferred
• Certified Scrum Product Owner (CSPO) or Certified Scrum Master (CSM) preferred

Knowledge, Skills & Abilities:

• Strong understanding of the Scrum framework and Agile development techniques
• Excellent business knowledge to lead development in coordination with all of the stakeholders
• Strong ability to produce concrete product features and subsequent roadmap while collaborating to drive implementation
• Strong understanding of the importance of efficient story writing and acceptance test-driven development
• Excellent knowledge of Microsoft Word, Excel, PowerPoint and Outlook
• Good knowledge of project management software, such as JIRA
• Excellent leadership and organizational skills
• Excellent written and verbal communication skills
• Strong ability to prioritize work and pivot focus as issues arise

The hiring salary range for this position will vary based on geographic location, falling within either the $83,925 - $15,647 range or 92,509 - 127,495 range. A hiring range represents a subset of the full salary range. The actual salary will depend on several factors, including relevant education, skills, and experience of an applicant, geographic location, and business needs.

Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws.

All of our locations are tobacco free including in company vehicles.

No Relocation Assistance Offered

Job Number #168622 - New York, New York, United States

Who We Are

Colgate-Palmolive Company is a global consumer products company operating in over 200 countries specializing in Oral Care, Personal Care, Home Care, Skin Care, and Pet Nutrition. Our products are trusted in more households than any other brand in the world, making us a household name!

Join Colgate-Palmolive, a caring, innovative growth company reimagining a healthier future for people, their pets, and our planet. Guided by our core values-Caring, Inclusive, and Courageous-we foster a culture that inspires our people to achieve common goals. Together, let's build a brighter, healthier future for all.

As a key member of the Global Benefits department, the Benefits Specialist is responsible for the smooth operation of our health and insurance benefits programs. Providing unparalleled service to our employees and retirees, this role involves detailed claims resolution, eligibility support, and continuous project engagement to enhance our benefits offerings. The right candidate will be a passionate advocate for employee health and wellness, keen to collaborate on complex issues and drive impactful benefits administration.

Responsibilities:

• Oversee day-to-day operations of select health & insurance benefits programs ensuring effective and efficient service delivery

• Resolve escalated health and insurance program claims and advocate for employees and retirees in benefits-related matters

• Help educate employees on their healthcare and group insurance benefits offerings, including plan provisions and claims processing

• Support and serve as a subject-matter expert on select benefit plan rules, acting as a liaison between the company, carriers, and benefit vendors

• Work with stakeholders across the organization to support the resolution of benefit issues and enhance process efficiencies

• Assist with implementation and management of programs, including communications campaigns and impact analysis

• Support annual benefits activities such as Open Enrollment, compliance reporting, and program valuation

• Participate in project work relating to benefit design, administration, systems development, and legislative compliance

• Stay informed about legislation and governmental requirements to assist in analyzing impacts on benefits programs in the U.S. and Puerto Rico.

• Additional duties as assigned, contributing to the successful operation of the company's health & insurance benefits services

Required Qualifications:

• Bachelor's degree

• 3+ years of experience with U.S. employee benefit programs, specifically in healthcare and group benefits

• Strong proficiency in Microsoft Excel, Google tools (docs, sheets, slides)

• Keen analytical skills and detail-oriented approach to problem-solving

Preferred Qualifications:

• Experience working with or within insurance carriers

• Able to handle multiple tasks simultaneously and prioritize optimally

• Exceptional customer service skills, serving both internal and external stakeholders

• Strong oral and written communication skills for clear and effective interaction

• Capable of working independently as a self-starter and as a collaborative team member

• A fast learner who is quality conscious and committed to meeting tight deadlines

• Demonstrates an inquisitive attitude, willing to ask questions to fully understand issues and concerns

Compensation and Benefits

Salary Range $83,200.00 - $117,500.00 USD

Pay is determined based on experience, qualifications, and location. Salaried employees may also be eligible for discretionary bonuses, profit-sharing, and long-term incentives for Executive-level roles.

Benefits: Salaried employees enjoy a comprehensive benefits package, including medical, dental, vision, basic life insurance, paid parental leave, disability coverage, and participation in the 401(k) retirement plan with company matching contributions subject to eligibility requirements. Additional benefits include a minimum of 15 vacation/PTO days (hourly employees receive a minimum of 120 hours) and 13 paid holidays (vacation days are prorated based on the employee's hire date within the calendar year). Paid sick leave is adjusted based on role and location in accordance with local laws. Detailed information regarding paid sick leave entitlements will be provided to employees upon hiring and may be subject to adjustments based on changes in legislation or company policies.

Our Commitment to Inclusion

Our journey begins with our people-developing strong talent with diverse backgrounds and perspectives to best serve our consumers around the world and fostering an inclusive environment where everyone feels a true sense of belonging. We are dedicated to ensuring that each individual can be their authentic self, is treated with respect, and is empowered by leadership to contribute meaningfully to our business.

Equal Opportunity Employer

Colgate is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, ethnicity, age, disability, marital status, veteran status (United States positions), or any other characteristic protected by law.

Reasonable accommodation during the application process is available for persons with disabilities. Please complete this request form ( should you require accommodation.

For additional Colgate terms and conditions, please click here ( .

#LI-Hybrid

No Relocation Assistance Offered
Job Number #168622 - New York, New York, United States
**Who We Are**
Colgate-Palmolive Company is a global consumer products company operating in over 200 countries specializing in Oral Care, Personal Care, Home Care, Skin Care, and Pet Nutrition. Our products are trusted in more households than any other brand in the world, making us a household name!
Join Colgate-Palmolive, a caring, innovative growth company reimagining a healthier future for people, their pets, and our planet. Guided by our core values-Caring, Inclusive, and Courageous-we foster a culture that inspires our people to achieve common goals. Together, let's build a brighter, healthier future for all.
As a key member of the Global Benefits department, the Benefits Specialist is responsible for the smooth operation of our health and insurance benefits programs. Providing unparalleled service to our employees and retirees, this role involves detailed claims resolution, eligibility support, and continuous project engagement to enhance our benefits offerings. The right candidate will be a passionate advocate for employee health and wellness, keen to collaborate on complex issues and drive impactful benefits administration.
Responsibilities:
+ Oversee day-to-day operations of select health & insurance benefits programs ensuring effective and efficient service delivery
+ Resolve escalated health and insurance program claims and advocate for employees and retirees in benefits-related matters
+ Help educate employees on their healthcare and group insurance benefits offerings, including plan provisions and claims processing
+ Support and serve as a subject-matter expert on select benefit plan rules, acting as a liaison between the company, carriers, and benefit vendors
+ Work with stakeholders across the organization to support the resolution of benefit issues and enhance process efficiencies
+ Assist with implementation and management of programs, including communications campaigns and impact analysis
+ Support annual benefits activities such as Open Enrollment, compliance reporting, and program valuation
+ Participate in project work relating to benefit design, administration, systems development, and legislative compliance
+ Stay informed about legislation and governmental requirements to assist in analyzing impacts on benefits programs in the U.S. and Puerto Rico.
+ Additional duties as assigned, contributing to the successful operation of the company's health & insurance benefits services
Required Qualifications:
+ Bachelor's degree
+ 3+ years of experience with U.S. employee benefit programs, specifically in healthcare and group benefits
+ Strong proficiency in Microsoft Excel, Google tools (docs, sheets, slides)
+ Keen analytical skills and detail-oriented approach to problem-solving
Preferred Qualifications:
+ Experience working with or within insurance carriers
+ Able to handle multiple tasks simultaneously and prioritize optimally
+ Exceptional customer service skills, serving both internal and external stakeholders
+ Strong oral and written communication skills for clear and effective interaction
+ Capable of working independently as a self-starter and as a collaborative team member
+ A fast learner who is quality conscious and committed to meeting tight deadlines
+ Demonstrates an inquisitive attitude, willing to ask questions to fully understand issues and concerns
**Compensation and Benefits**
Salary Range $83,200.00 - $117,500.00 USD
Pay is determined based on experience, qualifications, and location. Salaried employees may also be eligible for discretionary bonuses, profit-sharing, and long-term incentives for Executive-level roles.
Benefits: Salaried employees enjoy a comprehensive benefits package, including medical, dental, vision, basic life insurance, paid parental leave, disability coverage, and participation in the 401(k) retirement plan with company matching contributions subject to eligibility requirements. Additional benefits include a minimum of 15 vacation/PTO days (hourly employees receive a minimum of 120 hours) and 13 paid holidays (vacation days are prorated based on the employee's hire date within the calendar year). Paid sick leave is adjusted based on role and location in accordance with local laws. Detailed information regarding paid sick leave entitlements will be provided to employees upon hiring and may be subject to adjustments based on changes in legislation or company policies.
**Our Commitment to Inclusion**
Our journey begins with our people-developing strong talent with diverse backgrounds and perspectives to best serve our consumers around the world and fostering an inclusive environment where everyone feels a true sense of belonging. We are dedicated to ensuring that each individual can be their authentic self, is treated with respect, and is empowered by leadership to contribute meaningfully to our business.
**Equal Opportunity Employer**
Colgate is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, ethnicity, age, disability, marital status, veteran status (United States positions), or any other characteristic protected by law.
Reasonable accommodation during the application process is available for persons with disabilities. Please complete this request form ( should you require accommodation.
For additional Colgate terms and conditions, please click here ( .
#LI-Hybrid