Home Health and Hospice Prior Authorizations Specalist

Pennant Group; Oregon; Hybrid; USD 32,000 - 39,000; Full time

Benefits offered by this job

Comprehensive medical, dental, and vis

Free health concierge services

FSA and HSA accounts

Paid life and AD&D insurance

Paid sick, holidays, PTO

Job summary

Alpha Home Health & Hospice is hiring an Insurance Prior Authorization Specialist for on-site work in Mount Vernon, WA or remote work within PST/MST zones. The role requires 1+ year in insurance authorization in home health or hospice, and familiarity with Home Care Home Base (HCHB).

You will verify coverage, obtain authorizations, enter data in patient records, and support coordination with clinical and office staff. Competitive benefits and room for growth are offered.

Qualifications

• At least 1 year of insurance authorization/billing in home health/hospice.
• Experience with Home Care Home Base is required.
• Remote work considered only if in PST or MST time zones.

Responsibilities

• Verify insurance coverage for primary and secondary payors.
• Use UGS/DDE and EDS to verify Medicare/Medicaid eligibility.
• Obtain visit authorization and provide medical records as needed.
• Enter data accurately in patient records in HCHB.
• Maintain payor files and assist with appeals for denials.

Skills

Insurance authorization experience

Home health hospice

Customer service

Multi-tasking

Verbal and written communication

Tools

Home Care Home Base

Job description

Join Our Team as an Insurance Prior Authorization Specialist at Alpha Home Health & Hospice. On-site in our office located in Mount Vernon, WA or remote in PST or MST time zones only.

Benefits

• Benefits:$23-28 per hour, DOEComprehensive Medical, Dental, and Vision insuranceFree health concierge servicesFSA and HSA accountsPaid Life and AD&D insurancePaid Sick, Holidays, and PTOSTD, LTD, and other voluntary insurance plansCompany-wide celebrations of your great work & accomplishmentsSupport for your professional growth and developmentRoom for advancementAMAZING teammates & leaders who are supportive, inclusive, and fun!

What Do We Require of a Prior Authorization Specialist?

• MUST have at least 1 year of insurance authorization/billing experience in home health/hospice.Experience with Home Care Home Base is requiredPrefer onsite but will consider remote if candidate lives in PST or MST time zonesDemonstrated cooperation and excellent customer service skillsAbility to multi-task and stay on task in a fast-paced officeExcellent team-oriented, verbal, and written communication skills

Key Responsibilities

• Verify insurance coverage, including primary and secondary payorsUse UGS/DDE and EDS programs to verify Medicare/Medicaid eligibilityObtain visit authorization via payor by providing appropriate medical recordsPerform accurate data entry in patient records within HCHBMaintain payor files with up-to-date requirements to obtain/initiate appeals for denied authorizationsInterface with contract, clinical, and office staff to foster collaboration and positive working relationshipsPrepare patient co-pay estimates and notify scheduling of authorized visitsProvide excellent customer service to patients, referral sources, and community contacts with questions regarding payor prior authorizations and medical guidelinesEnter, audit, and follow up on authorized and unauthorized visits within HCHB

Why Alpha Home Health & Hospice?

At Alpha Home Health & Hospice, we pride ourselves on our quality of care and ethical business practices, guided by our foundational

Core Values of CAPLICO :C ustomer Second (Employee First!)A ccountabilityP assion for LearningL ove One AnotherI ntelligent Risk TakingC elebrationO wnership

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 .