Authorization Automation Specialist

Healing Strides Counseling; New York (NY); On-site; USD 65,000 - 90,000; Full time

Job summary

Healing Strides Counseling seeks an experienced Prior Authorization Specialist to support automation for home health and hospice. You will ensure authorizations align with payer requirements and help translate complex rules into scalable workflows.

Join a fast-moving startup where you’ll partner with product, engineering, and client teams to reduce turnaround times, monitor denial trends, and build SOPs that cover Medicare Advantage, Medicaid, and commercial payers.

Qualifications

• 3+ years of prior authorization in home health, hospice, or post-acute care.
• Deep knowledge of Medicare Advantage, Medicaid, managed Medicaid, and commercial payers.
• Experience obtaining authorizations across multiple payer portals.
• Strong organizational skills and attention to detail; experience documenting workflows.

Responsibilities

• Audit authorization workflows.
• Review automation-generated requests for completeness, accuracy, and turnaround time.
• Improve automation by translating payer rules into scalable workflows.
• Build payer playbooks and SOPs across Medicare Advantage, Medicaid, and state programs.
• Partner with clients to align automation with agency workflows.
• Track performance metrics and drive continuous improvement.

Skills

Prior authorization experience

Medicare & Medicaid knowledge

Workflow documentation

Independent startup environment

Attention to detail

Education

Clinical background (RN/LPN or similar)

Tools

HomeCare HomeBase (HCHB)

Axxess

WellSky

KanTime

Job description

Healing Strides Counseling seeks an experienced Prior Authorization Specialist to support automation for home health and hospice. You will ensure authorizations align with payer requirements and help translate complex rules into scalable workflows.

Join a fast-moving startup where you’ll partner with product, engineering, and client teams to reduce turnaround times, monitor denial trends, and build SOPs that cover Medicare Advantage, Medicaid, and commercial payers.