authorization specialist - KaiserTSG Outsourcing
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Rate: $500.00/month and earn up to 28,400 PHP
Schedule: Thursday to Monday 9:00am -5:00pm PST, with 1 hour Lunch break
Qualifications:
Must have prior experience handling Kaiser authorizations (this is a non-negotiable requirement).
Strong knowledge of insurance verification processes for home health services, including Medicare Advantage and commercial insurance.
Experience with Wellsky Kinnser software for documentation and patient care coordination.
Proficiency in insurance verification, obtaining prior authorizations, and resolving payer issues.
Excellent communication and customer service skills to interact with patients, caregivers, and insurance companies.
Familiarity with patient demographics and managing payer changes in healthcare systems.
Ability to multitask and handle a high volume of cases, with attention to detail and accuracy.
Knowledge of home health services and understanding of cost and benefits related to these services.
Strong problem-solving skills and the ability to seek assistance when necessary.
High school diploma or equivalent; additional education or certifications in medical billing or healthcare administration are a plus.
Responsibilities:
Handle insurance verification for patient admissions and recertification, ensuring accuracy and timeliness.
Initiate Kaiser authorizations and maintain accurate documentation with minimal errors.
Collaborate with the Billing and Patient Care teams to resolve insurance-related issues.
Enter and update patient demographics and insurance information in the system, including new payer setups.
Coordinate with admission and scheduling departments to ensure patients receive timely care.
Obtain prior authorizations as needed and follow up on case statuses to ensure compliance.
Re-verify out-of-network benefits at the start of each month and document the findings.
Provide detailed documentation of insurance plan benefits and authorizations in the Wellsky Kinnser software.
Communicate with insurance companies to obtain, verify, and update patient insurance information, ensuring all details are accurate and current.
Act as part of the patient care team, supporting clinical staff with cost and benefits knowledge related to home health services.
Assist with reporting and data gathering for the department as needed, contributing to overall operational efficiency.
Maintain up-to-date records and handle payer changes efficiently within the EHR system.
Provide prompt and effective customer service to patients and their families regarding authorization and insurance concerns.
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TSG Outsourcing
About the company
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