Insurance Specialist
Listed on 2026-02-03
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Healthcare
Healthcare Administration
Position Summary
The Research Insurance Specialist is essential in the success of supporting clinical trials. The primary task is to verify insurance policy benefit information and obtain authorizations/pre-certifications for services not covered by the clinical trial study. The Research Insurance Specialist will verify with the clinical trial patient’s insurance provider if the incumbent has coverage to participate in the proposed trial. If approved, and using a clinical trial study coverage analysis, the researcher will determine for each upcoming appointment whether the upcoming service will be covered by the study sponsor or if the service needs prior authorization from the patient’s insurance.
The Research Insurance Specialist is responsible for obtaining timely authorizations/pre-certifications when needed for all services not covered under the study.
- Review billing grid/budget and compile list of all standard of care procedures associated to research
- Verify hospital and professional insurance policy benefits for clinical trial patients. The verification process includes: telephone contact, mail/facsimile, online inquiry
- Enter information concerning the policy benefits into the system and update insurance information in the system
- Review billing grid/budget to determine if upcoming services require authorization and update in medical record
- Request authorization extension or new authorizations for continuity of care for research as needed or when coverage changes, and input updates into the system
- Receive and read City of Hope managed care contract summaries to obtain an understanding of the contract provisions and interpret for insurance coverage; act as resource regarding managed‑care contract changes and updates
Your qualifications should include:
- High School Diploma
- 2 years of related experience and 1+ years of healthcare experience
City of Hope employees pay is based on the following criteria: work experience, qualifications, and work location.
City of Hope is an equal opportunity employer.
To learn more about our Comprehensive Benefits, please .
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