Authorization & Orders Specialist

Excell Home Care & Hospice; Oklahoma City (OK); On-site; USD 42,000 - 65,000; Full time

Job summary

The Pennant Group is seeking a Home Health Care Coordinator to manage care plans for managed care patients and maintain positive relationships with care partners in Oklahoma City. You will coordinate patient plans of care, coordinate authorizations, and ensure compliance with contractual requirements.

Responsibilities include working with nursing staff, billing teams, and physicians to ensure timely care delivery, maintaining EMR proficiency across platforms, and upholding high-quality patient

Qualifications

• At least 1 year of experience in health care managed care coordination, preferably in home health care.
• Knowledge of corporate business management and managed care environment.
• Good communication and public relations skills.
• Demonstrates autonomy, organization, assertiveness, flexibility, and cooperation in performing responsibilities.
• Knowledge Word, Excel, Adobe PDF.
• Demonstrates ease of working with multiple EMR platforms.

Responsibilities

• Verifies insurance coverage and obtains initial authorizations for services and seeks reauthorization for ongoing and additional services.
• Works with Director or Nursing and staff clinicians to gather, collate, and report patient care summary information to managed care Case Managers with other insurances.
• Maintains comprehensive working knowledge of managed care contractual relationships and ensures patients are admitted and services delivered per contract provisions.
• Collaborates with billing team to ensure managed care customers are billed according to Case Manager Agreements.
• Establishes and maintains positive working relationships with current and potential managed care customers.
• Responds promptly to managed care customer requests and concerns.
• Assists in building community, customer, payer and patient perceptions of Excell Home Care & Hospice as a high-quality provider of services.
• Maintains comprehensive working knowledge in managed care and shares information with appropriate organization personnel.
• Performs/oversees Order/F2F Tracking: monitors Plan of Treatment, signs and dates physician orders, encodes orders.
• Oversees open orders report for timely approval; regenerates late orders for signature; coordinates with physicians as appropriate.
• Manages clinical records functions including establishing and implementing clinical records policies.
• Ensures clinical record systems are compliant with state, federal and regulatory requirements.
• Protects all clinical records through control procedures for open and closed records.
• Protects confidentiality of patient and organizational information via effective controls.
• Forwards copies of clinical records to authorized users per policy.
• Monitors unsigned physician orders and prompts second/third requests for signed orders if overdue.
• Supervises clinical records system and coordinates upgrades and enhancements.

Skills

Healthcare coordination

Public relations

Communication

Autonomy

Organization

Assertiveness

EMR proficiency

Team collaboration

Tools

Microsoft Word

Microsoft Excel

Adobe PDF

Job description

Celebrating 30 years in 2026!Be part of Excell's legacy of providing life-changing service!Excell has been located in SW OKC since 1996 and has a history of high-quality care, by skilled professionals.Excell’s Legacy of Excellence is to provide Life-Changing Services to our Oklahomans. We are celebrating 30! You canbe part of a historic legacy that lives into the future! Be an advocate for quality of care, you and your ‘why’ change thelives of our patients, families, and healthcare partnerships in our Oklahoma City community. Come be a beacon, andbuild into our legacy your passion, your reason for life-changing care. We know why we do this noble work, and justlike you, together we make our reason the one to call Excell Home Care & Hospice, Home.HOME HEALTH & HOSPICE EXPERIENCE PREFERREDHCHB/POINTCARE EXPERIENCE IS A PLUS!JOB SUMMARYResponsible for coordinating home care services for managed care patients, which includes establishing andmaintaining the patient’s plan of care, establishing and maintaining positive relationships with managed carecustomers and related referral sources.DUTIES & RESPONSIBILITIES1. Verifies insurance coverage and obtains initial authorizations for services and seeks reauthorization for ongoinand additional services.2. Works with Director or Nursing and staff clinicians to gather, collate, and report patient care summaryinformation to managed care Case Managers with other insurances.3. Maintains comprehensive working knowledge of managed care contractual relationships and ensures thatpatients are admitted, and services are delivered in accordance with contract provisions.4. Works with members of the billing team to ensure that managed care customers are billed according to CaseManager Agreements.5. Establishes and maintains positive working relationships with current and potential managed care customers.6. Promptly responds to managed care customer’s requests and concerns.7. Assists in building community, customer, and payer and patient perceptions of Excell Home Care & Hospice as ahigh-quality provider of services.8. Maintains comprehensive working knowledge in the field of managed care and shares information witappropriate organization personnel.9. Performs/oversees: Order/F2F Tracking-monitors all aspects of Plan of Treatment/order tracking, to includechecking in orders/Plan of Treatment on a daily basis, verifying all incoming orders are signed and dated byphysician and/or Excell staff as appropriate. Accurately encodes physician orders, Medicarecertification/recertificati10. Performs/oversees open orders report for timely approval. Regenerates late orders for signature (Supplemental14 days, Certification 21 days). Works with physician liaisons as appropriat11. Manages clinical records functions including establishing and implementing clinical records policies.12. Ensures clinical record systems are maintained in compliance with state, federal and regulations.13. Protects all clinical records through the establishment and implementation of control procedures for all openand closed records.14. Protects the confidentiality of patient and organization information through effective controls and direct supervision of clinical records.15. Forwards copies of clinical records to authorized users according to policy.16. Monitors aged unsigned physician orders and submits second and third requests for signed orders to overduephysicians, calls or visit the offices of seriously overdue physician17. Supervises the use of the clinical records information system and mains a comprehensive working knowledgeof the system including upgrades and enhancements.JOB REQUIREMENTS (Education, Experience, Knowledge, Skills & Abilities)1. At least one year of experience in health care managed care coordination, preferably in home health care or aninternship of comparison, preferred.2. Complies with acceptable professional standards and practice.3. Knowledge of corporate business management and managed care environment.4. Demonstrates good communication and public relations skills.5. Demonstrates autonomy, organization, assertiveness, flexibility, and cooperation in performing joresponsibilities.6. Knowledge Word, Excell, Adobe PDF.7. Demonstrate ease of working with multiple EMR platforms.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.