Insurance Authorization Coordinator

This is a fully remote position, open to applicants in Idaho.

📋 Description

• Supervise the prompt and precise submission and monitoring of initial insurance authorization requests for home health and hospice patients.

• Collaborate with scheduling teams to arrange the start of care, ensuring that clinical services are provided only after authorization has been confirmed.

• Direct the authorization process following the submission of the 485 Plan of Care.

• Manage additional insurance authorizations for adjustments in the patient's plan of care, such as increased visits or new services.

• Establish and oversee re-verification of eligibility on the 1st and 5th of each month for all active patients.

• Identify and address changes in insurance status proactively.

• Serve as the escalation point for complex authorization denials or issues, communicating directly with insurance carriers.

• Ensure that authorization processes adhere to payer contracts and regulatory standards.

• Produce reports on authorization status, denial rates, and turnaround times.

• Lead a vital insurance authorization function that supports continuous patient care and financial stability.

⛳️ Requirements

• A minimum of 3 years of specialized experience in insurance verification and authorization, particularly within Home Health or Hospice.

• In-depth knowledge of Medicare, Medicaid, and commercial insurance authorization processes and documentation requirements for episodic and per diem payments.

• Proficient in utilizing electronic medical record (EMR) systems and authorization tracking software.

• Exceptional analytical and organizational skills with a keen attention to detail.

• Outstanding ability to navigate complex payer portals and communication pathways.

• Excellent interpersonal skills for effective collaboration with clinical and scheduling teams.

• Proven capability to lead a team in a high-volume, deadline-oriented environment.

• Strong dedication to regulatory compliance and ethical billing practices.

• An Associate's or Bachelor's degree in Business, Finance, Healthcare Administration, or a related field is preferred.

• Experience with utilization review and appeals processes is preferred.

🏝️ Benefits

• Comprehensive health and wellness benefits package.

• Opportunities for professional development and career advancement.

• Supportive work environment with a focus on work-life balance.