Inpatient Authorization Specialist & Payer Liaison

KPC Health, Inc.; Santa Ana, Northern (CA, KY); Hybrid; USD 31,000 - 52,000; Full time

Job summary

KPC Health, Inc. in Santa Ana, CA is seeking an Authorization Specialist to ensure timely verification and validation of authorizations for Commercial and Managed Care inpatients and other services.

The role requires contacting insurance companies, reviewing discharged patients for authorization entries, and obtaining missing authorizations within defined timeframes. The position emphasizes accurate documentation and cross‑department collaboration.

Qualifications

• High school diploma or equivalent.
• Minimum of two (2) years of experience in scheduling, authorization and referrals in a health care setting.

Responsibilities

• Verify and validate authorizations for Commercial and Managed care inpatients and other services.
• Contact insurance companies by phone or website to secure authorization.
• Review discharged managed care patients for authorization entries in the system.
• Obtain missing authorizations within 3 business days of discharge or within 7 days of admission in some cases.
• Check bill hold weekly for pending authorizations.
• Assist with sending delinquent reviews and resending reviews not received by payors.
• Communicate with Case Management and other departments to obtain authorizations.
• Maintain analysis of authorization issues by payer and report monthly to senior leadership.
• Document all contacts and authorization information in the hospital system per documentation standards.
• Follow hospital policies and procedures regarding authorization processes.
• Other duties as assigned.

Skills

Attention to detail

Communication skills

Follow-up skills

Education

High school diploma

Job description

KPC Health, Inc. in Santa Ana, CA is seeking an Authorization Specialist to ensure timely verification and validation of authorizations for Commercial and Managed Care inpatients and other services.

The role requires contacting insurance companies, reviewing discharged patients for authorization entries, and obtaining missing authorizations within defined timeframes. The position emphasizes accurate documentation and cross‑department collaboration.