Insurance Authorization Specialist - West - KidsCare Home Health

Pursue your passion and fulfill your purpose at KidsCare! KidsCare Home Health is a multi-award-winning organization who was most recently recognized as a 2024 U.S. Top Workplace. As an award-winning organization, we are looking for dedicated professionals who will embrace the KidsCare core values. At KidsCare we desire to work with individuals who embody the values of the organization which together create our C.A.R.E. culture. In return we offer a full benefits package to include health, dental, and vision insurance, paid time off, 401K, tuition reimbursement, and a hybrid or blended work arrangement (providing balance between in office and work from home).

We are currently looking for an Insurance Authorization Specialist to join our team! This position works with multiple payer sources, obtain insurance authorization for physician ordered services. Monitor and recertify authorization prior to current expiration date. 

Essential Duties and Responsibilities 

• Maintain authorization workflows to obtain routine, initial and reauthorizations. 
• Schedule authorized visits to clinician’s caseload. 
• Process authorization emails and/or kickbacks received from payer. 
• Participate in proactive team efforts to achieve departmental and company goals. 
• Communicate with caregiver and clinicians to provide updates as needed. 
• Keep up to date with all payor requirements and procedural changes for each payer. 
• Contact payer sources for outstanding authorizations, including fax authorization requests with necessary clinical documentation to obtain authorization. 
• Prepare and fax authorization documentation to physician for signature. 
• Process payer changes each month. 
• Ensure timely processing of discharge and managing clients’ holds in the organization’s healthcare software system.  
• Anticipate and facilitate orders needed for upcoming episodes to maintain continuation of care.  
• Comply with all safety policies, practices and proceduresand report unsafe activity to your supervisor. 
• Other duties as assigned. 

Other Qualifications and Skills 

• Ability to carry out detailed but involved written instructions, able to problem solve with few variables. 
• Ability to communicate clearly, written and verbally. 
• Adaptability and self-motivated. 
• Microsoft Office and database activity. 
• Handle multiple tasks simultaneously. 

 Education andWork Experience 

•  Zero (0) – One (1)  years of administrative experience preferred. 
• High school diploma or general education degree (GED); combination of education and 1 year of experience. 

Physical Demands/Working Environment   

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  

• While performing the duties of this job, the employee is regularly required to, stand, sit; talk, hear, and use hands and fingers to operate a computer and telephone keyboard. 
• Ability to sit at a computer for an extended period. 
• Light to moderate physical activity and lifting is required. 
• Specific vision abilities required by this job include close vision requirements. 
• Moderate noise (i.e., business office with computers, phone, and printers, light traffic).