Healthcare Eligibility & Authorization Specialist

AgeRight Care Management; Milwaukie (OR); On-site; USD 42,000 - 56,000; Full time

Job summary

AgeRight Care at Home in Milwaukie, OR is seeking an Home Health Eligibility & Authorization Coordinator to coordinate insurance verification, prior authorizations, and documentation requirements to ensure timely admission and continuation of home health services.

You will verify eligibility, track authorizations, review payer requirements, and maintain records in EMR systems, working with referrals, clinicians, and payers to minimize denials and support compliant, patient-centered care.

Qualifications

• High school diploma required; associate or bachelor degree preferred.
• Experience in home health intake, insurance verification, authorizations, or healthcare administration preferred.

Responsibilities

• Verify insurance eligibility and benefits prior to admission.
• Obtain and track prior authorizations and recertifications.
• Review referrals for payer requirements and coverage criteria.
• Coordinate with referral sources, clinicians, and payers.
• Maintain authorization logs and expiration dates.
• Resolve authorization denials and request additional documentation.
• Support timely intake processing and patient admission.
• Ensure compliance with CMS, Medicare, Medicaid, and commercial payer requirements.
• Maintain accurate records in EMR systems.
• Generate reports related to authorization status and payer trends.

Skills

Insurance verification

Authorization processing

Payer requirements

Communication

Documentation

Education

High school diploma

Associate or bachelor degree preferred

Tools

EMR systems

Job description

AgeRight Care at Home in Milwaukie, OR is seeking an Home Health Eligibility & Authorization Coordinator to coordinate insurance verification, prior authorizations, and documentation requirements to ensure timely admission and continuation of home health services.

You will verify eligibility, track authorizations, review payer requirements, and maintain records in EMR systems, working with referrals, clinicians, and payers to minimize denials and support compliant, patient-centered care.