Intake and Precertification Specialist – Home Health and Hospice

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

📋 Description

• Oversee the intake process for new patient referrals, which includes receiving referral details, verifying insurance, and arranging initial assessments.

• Act as the main point of contact for patients, families, referral sources, and healthcare professionals regarding the status of referrals and authorizations.

• Acquire and document both initial and ongoing authorization numbers utilizing EPIC or other electronic systems.

• Ensure precise documentation of precertification, authorization, and referral communications.

• Liaise with insurance companies to secure prior authorizations and address any authorization-related issues.

• Track authorization statuses and certification deadlines, ensuring the correct sequence of payors for billing purposes.

• Input and maintain patient referral and insurance data in the relevant systems.

• Organize scheduling for initial assessments in collaboration with clinical staff.

• Utilize knowledge of CPT and HCPC coding to precertify and authorize home health or hospice referrals.

• Support denial management, audits, and requests for documentation.

• Monitor referral activity to guarantee timely processing that aids admissions and billing.

• Communicate with internal departments concerning the status of authorizations and the advancement of referrals.

• Achieve productivity, throughput, turnaround times, and deadline goals.

• Deliver outstanding customer service to patients, families, referral sources, and care teams.

⛳️ Requirements

• High School Diploma or its equivalent.

• A minimum of two (2) years of experience in insurance verification, authorization, or healthcare intake.

• Familiarity with CPT, ICD 10, HCPC, LMRPs, and similar coding guidelines for post-acute care authorization.

• Understanding of third-party payor requirements, contracts, and practices related to authorization and payment.

• Experience with the EPIC platform is preferred, though other relevant systems will also be considered.

• Proficiency in medical terminology.

• Capability to consistently complete tasks effectively.

• Excellent communication skills to interact courteously and professionally with the public and healthcare team.

• Ability to prioritize and multitask effectively.

• Strong attention to detail, ensuring accuracy, efficiency, and timeliness in a high-volume, deadline-oriented environment.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and career advancement.

• Supportive work environment that values collaboration and innovation.