Healthcare Authorization Specialist

Canyon-Home-Care-and-Hospice-1; Loveland (CO); On-site; USD 42,000 - 52,000; Full time

Job summary

Canyon Home Care & Hospice is seeking a detail-oriented Authorization Specialist for our Loveland, CO office. You will verify patient eligibility, obtain authorizations for scheduled exams, and gather supporting clinical data to ensure timely payments from accepted payers.

Responsibilities include managing preauthorization, contacting patients for updated information, and coordinating with health plans to maintain high approval rates while keeping all teams aligned on patient insurance data.

Qualifications

• Current knowledge of medical terminology, insurance authorization and verification.
• Knowledge of ICD-Codes/CPT preferred.
• Strong technical skills (Word, Excel, Acrobat or similar product).
• Successful completion of or ability to complete state continuing education requirements.
• Excellent verbal and written communication skills and strong interpersonal skills.
• Ability to work in a fast paced setting.
• Knowledge of regulatory requirements at federal, state and local levels.
• At least 21 years of age.

Responsibilities

• Manage predetermination, authorization, and referral requirements for each health plan.
• Contact patients/referring offices for updated insurance information and records.
• Ensure that exams are authorized 48 hours prior to the date of service.
• Ensure same-day add-ons are authorized within 24 hours after exam completion.
• Coordinate with health plans to provide medical records and data to ensure 99% approval rate.
• Communicate with internal departments to keep patient insurance info accurate.

Skills

Medical terminology

Insurance authorization

Verification

Interpersonal skills

Verbal communication

Written communication

Regulatory knowledge

Fast-paced work

Tools

Word

Excel

Acrobat

Job description

Canyon Home Care & Hospice is seeking a detail-oriented Authorization Specialist for our Loveland, CO office. You will verify patient eligibility, obtain authorizations for scheduled exams, and gather supporting clinical data to ensure timely payments from accepted payers.

Responsibilities include managing preauthorization, contacting patients for updated information, and coordinating with health plans to maintain high approval rates while keeping all teams aligned on patient insurance data.