About the role
Insurance Authorization Coordinator
-
Home Health and Hospice
Join
Pennant’s
- dynamic
- insurance authorization
- team as
- the
Insurance Authorization Coordinator
- ! We are looking for an exceptional team player to
- orchestrate
- the crucial function of securing
- timely
- and
- accurate
- insurance authorizations for our patients. Your
- expertise
- will be key to ensuring uninterrupted care and
- optimizing
- our financial health.
About the Role
You will be
responsible for all aspects of payer authorization. This role demands deep knowledge of payer requirements, strong ownership skills, and meticulous attention to detail to ensure every patient's services are appropriately covered from admission through discharge.
Key Responsibilities
Initial Authorization
Oversee the
- timely
- and
- accurate
- submission and tracking of all
- initial
- insurance authorization
- requests for home health and
- hospice
- patients.
Collaboration and Communication
Work closely and eff
- ectively
- with the
- scheduling teams
- to coordinate start of care and ensure clinical services are only delivered after authorization is confirmed.
485 and Add-On Authorization
Direct the process for obtaining authorization following the
485 (Plan of Care)
- submission and managing all
- add-on insurance
- authorizations when
- required
- for changes in the patient's plan of care (e.g., increased visits, new services).
Ongoing Eligibility Management
Establish
- and monitor the process for the team to
- re-verify eligibility on the 1st and 5th of each month
- for all active patients to proactively
- identify
- and resolve any changes in insurance status.
Payer Relations
- Serve as the escalation point for complex
- authorization
- denials or issues, communicating directly with various insurance carriers.
Compliance and Reporting
Ensure all authorization processes are compliant with payer contracts and regulatory standards. Generate reports on authorization status, denial rates, and turnaround times.
Qualifications
Required
Minimum of 3 years of dedicated experience in
insurance verification and authorization , specifically within
Home Health or Hospice
.
Expert knowledge of
Medicare, Medicaid, and commercial insurance authorization processes
and documentation requirements for episodic and per diem payments.
Proficiency
in using electronic medical record (EMR) systems and authorization tracking software.
Preferred
Associate's
or
Bachelor's degree in Business
- , Finance, Healthcare Administration, or
- a related
- field.
Experience with
- utilization
- review and
- appeals
- processes.
Skills and Competencies
- Superior analytical and organizational skills
- with
- an unwavering
- attention to detail.
- Exceptional ability to navigate complex payer portals and communication channels.
- Excellent interpersonal skills for effective collaboration with clinical and scheduling staff.
- Proven ability to lead a team in a high-volume, deadline-driven environment.
- Strong commitment to regulatory compliance and ethical billing practices.
- If you are a results-oriented authorization expert ready to lead a critical function that ensures our patients receive the care they need, apply today!
The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at
http://www.pennantgroup.com.