Eligibility & Authorization Coordinator (Home Health)

Parx Home Health Care; Tampa (FL); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Health, dental, vision insurance

3 Weeks PTO & Holidays

401K with employer contribution

Voluntary Life Insurance

Critical Illness coverage

Job summary

Parx Home Health Care in Tampa, FL is seeking an Eligibility & Authorization Specialist to verify patient insurance benefits and obtain authorizations for home health services. You will collaborate with Intake, Revenue Cycle, and payer representatives to ensure financial clearance and continuous approvals.

Ideal candidate is organized, detail-oriented, comfortable with multiple payer portals, and able to manage high volumes while meeting deadlines.

Qualifications

• Verify insurance eligibility and benefits for home health patients.
• Confirm coverage for home health services including disciplines, visits, copays, deductibles, coinsurance, and patient responsibilities.
• Obtain initial and ongoing authorizations for skilled nursing, PT, OT, speech therapy, HHA, and other services.
• Submit authorization requests via payer portals, fax, phone, or other approved methods.
• Gather and submit clinical documentation to support authorization requests.
• Track authorization status and follow up with payers on pending requests.
• Maintain accurate authorization data in the EMR.

Responsibilities

• Verify insurance eligibility and benefits for new and existing home health patients.
• Confirm coverage for home health services incl. disciplines, visit limits, copays, and patient financial responsibilities.
• Obtain initial and ongoing authorizations for skilled services.
• Submit authorization requests through payer portals, fax, or phone.
• Gather and submit clinical documentation to support requests.
• Track status and follow up on pending authorizations.
• Maintain authorization data in the EMR and communicate approvals/denials.

Skills

Insurance verification

Authorization management

Payer portals

Attention to detail

Time management

Tools

EMR system

Job description

The Eligibility & Authorization Specialistis responsible forverifying patient insurance benefits and obtaining, tracking, andmaintainingrequired authorizations for home health services. This position works closely with Intake,Revenue Cycle, agency staff, and payer representatives to ensure patients are financially cleared forservicesand that required authorizations are obtained andmaintainedthroughout the episode of care.The ideal candidate is highly organized, detail-oriented, comfortable working with multiple payer portals, and able to manage a high volume of patients while meeting time-sensitive deadlines.

Home Health Authorization experience is preferred.

• Verify insurance eligibility and benefits for new and existing home health patients.

• Confirm coverage for home health services, including applicable disciplines, visit limitations, copays, deductibles, coinsurance, and other patient financial responsibilities.

• Obtain initial and ongoing authorizations for skilled nursing, physical therapy, occupational therapy, speech therapy, home health aide, and other covered home health services.

• Submit authorization requests through payer portals, fax, phone, or other required methods.

• Gather andsubmitrequired clinical documentation to support authorization requests.

• Track authorization status and follow up with payers on pending requests.

• Maintainaccurateauthorization dates, approved disciplines, visit quantities, authorization numbers, and other requirements within the EMR.

• Request extensions or additional visits timely to prevent interruptions in patient care.

• Communicate authorization approvals, limitations, denials, and outstanding requirementsaccordingly.

• Research and resolve eligibility discrepancies, authorization issues, and payer-related barriers.

• Maintain knowledge of payer-specific requirements and changes in authorization processes.

• Document all payer communications and authorizationactivityaccuratelyand timely.

• Assistwithidentifyingpotential authorization-related billing issues before claims aresubmitted.

• Maintain patient confidentiality andcomply withHIPAA and all applicable company policies and procedures.

• Perform other related duties as assigned.

What We Offer-Our Work/Life Balance

• A workplace where your ideas and voice actually matter
• Supportive leadership
• Competitive salary
• Health, dental, vision insurance
• 3 Weeks Paid Time Off & Holiday Pay
• Health, Vision, Dental Benefits
• 401K plus Employer Contribution
• Voluntary Life Insurance
• Critical Illness, Group Hospital Indemnity, Accident Insurance