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 gathering referral information, verifying insurance, and scheduling 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, referrals, and communications.

• Engage with insurance providers to secure prior authorizations and address related issues.

• Keep track of authorization statuses, certifications, recertifications, and payer sequencing for billing purposes.

• Input and update patient referral and insurance details in the appropriate systems.

• Coordinate the scheduling of initial assessments with clinical staff.

• Stay updated on CPT and HCPCS coding to facilitate the precertification/authorization of home health and hospice referrals.

• Aid in managing denials, audits, and requests for documentation.

• Monitor referral activity to ensure prompt processing that supports admissions and billing.

• Relay authorization statuses and referral updates to internal departments.

• Achieve productivity, throughput, turnaround time, and deadline goals in a high-volume referral setting.

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

⛳️ Requirements

• High School Diploma or an equivalent qualification.

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

• Familiarity with CPT, ICD 10, HCPC, LMRPs, and related coding/guidelines.

• Understanding of third-party payor requirements, contracts, authorizations, and payment practices.

• Preference for knowledge of the EPIC platform; experience with other relevant systems is also acceptable.

• Experience with medical terminology.

• Capability to consistently complete assigned tasks.

• Effective communication skills with the public and healthcare team in a professional and courteous manner.

• Ability to prioritize and multitask effectively.

• Scheduled weekly hours: 40.

🏝️ Benefits

• Comprehensive health insurance plans.

• Opportunities for professional development and continuing education.

• Supportive work environment with a focus on teamwork.

• Competitive salary and performance-based incentives.