At Kaiser Permanente - Central Patient Financial Office, I researched authorization, insurance verification, eligibility, benefits, and reimbursement requirements across commercial plans, Medicare, Medicaid/Medi-Cal, and Workers' Compensation.
I conducted benefit investigations and payer-policy analyses for 40+ patients daily, reviewing clinical documentation and medical-necessity criteria to determine authorization and financial-clearance actions.
As a dedicated Medi-Cal specialist, I provided subject-matter support on complex California Medicaid eligibility, benefits, authorization, and account resolution.
Earlier, at Muir Orthopaedic Specialists and Pacific Pulmonary Services, I researched payer requirements for diagnostic procedures and DME and respiratory accounts, and supported appeals and reconsiderations.
