Responsibilities
- Conduct insurance verification through payer portals, phone calls, and HCHB’s integrated tools for all new referrals and ongoing patients.
- Initiate and obtain prior authorizations for home health services including nursing, therapy, and aide services as required by payers.
- Accurately enter and maintain insurance, authorization, and eligibility information within the HCHB system in real-time.
- Review patient intake information to ensure payer requirements are identified and addressed early in the admission process.
- Collaborate with intake, clinical staff, case managers, and billing teams to resolve authorization-related issues promptly
- Follow up proactively with insurance companies to ensure timely processing of authorizations and appeals.
- Stay current on payer-specific authorization protocols, documentation requirements, and changes to coverage policies affecting home health.
- Ensure compliance with HIPAA, Medicare Conditions of Participation, and other regulatory standards.
- Maintain organized and auditable records of all insurance and authorization communications and decisions within HCHB and agency systems
Requirements
- High school diploma or equivalent
- Minimum 2 years of experience in home health authorization/eligibility processes.
- Strong understanding of traditional Medicare, Medicare Advantage, and commercial insurance guidelines.
- Experience navigating payer websites/portals (e.g., Availity, Waystar, Palmetto etc.).
- Detail-oriented with excellent organizational and follow-up skills.
- Effective communication and customer service skills with both internal teams and external payers.
- Ability to multitask in a high-volume, fast-paced remote or office environment.
- Must have and maintain valid Driver’s License, and proof of current valid auto liability insurance.
Nice to Have
- Associate degree or higher
- Proficiency in Homecare Homebase (HCHB)
Benefits
- Medical, Dental & Vision
- Pharmacy Benefits
- Virtual & Mental Health Support
- Flexible Spending Accounts (FSAs) & Health Savings Account (HSA)
- Supplemental Health & Life Insurance
- 401(k) with Company Match
- Employee Referral Program
- Prepaid Legal Plans
- Identity Theft Protection
- Paid Time Off
- Pet Insurance
- Tuition & Continuing Education Reimbursement
Work Arrangement
Remote (Worldwide)
Additional Information
- Ideal candidate should reside in Texas, Louisiana, Mississippi, Florida, or Alabama
- 6 weeks of paid time off each year
- Work deals mostly with areas such as preparing and reading data and figures, records, reports, visual inspection involving small details. Although important, depth perception and field of vision (peripheral) are not as critical as the ability to distinguish small details and markings very near to the observer.
