Home Health and Hospice Prior Authorizations Specalist

Alpha Home Health and Hospice; United States; Hybrid; USD 32,000 - 39,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time off

Life & AD&D insurance

Sick/Holidays & PTO

Health concierge services

Job summary

Alpha Home Health & Hospice is seeking an Insurance Prior Authorization Specialist. This role supports insurance verification and authorization processes for home health and hospice patients. On-site in Mount Vernon, WA or remote for candidates in PST/MST time zones.

Competitive hourly pay and comprehensive benefits are included. The ideal candidate has at least 1 year of insurance authorization/billing experience, proficiency with Home Care Home Base, and strong customer service skills in a

Qualifications

• Must have at least 1 year of insurance authorization/billing experience in home health/hospice.
• Experience with Home Care Home Base (HCHB) is required.
• Remote work considered only for candidates 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 by providing relevant medical records.
• Enter data accurately in patient records within HCHB.
• Maintain payor files with up-to-date requirements and initiate appeals for denials.
• Collaborate with contract, clinical, and office staff.
• Prepare patient co-pay estimates and notify scheduling of visits.
• Provide excellent customer service to patients and referral sources.

Skills

Insurance authorization

Billing

Customer service

Multi-tasking

Verbal communication

Written communication

Tools

Home Care Home Base (HCHB)

UGS/DDE

EDS

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:

• $23-28 per hour, DOE
• Comprehensive Medical, Dental, and Vision insurance
• Free health concierge services
• FSA and HSA accountsPaid Life and AD&D insurance
• Paid Sick, Holidays, and PTO
• STD, LTD, and other voluntary insurance plans
• Company-wide celebrations of your great work & accomplishments
• Support for your professional growth and development
• Room for advancement
• AMAZING 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 required
• Prefer onsite but will consider remote if candidate lives in PST or MST time zones
• Demonstrated cooperation and excellent customer service skills
• Ability to multi-task and stay on task in a fast-paced office
• Excellent team-oriented, verbal, and written communication skills

Key Responsibilities:

• Verify insurance coverage, including primary and secondary payors
• Use UGS/DDE and EDS programs to verify Medicare/Medicaid eligibility
• Obtain visit authorization via payor by providing appropriate medical records
• Perform accurate data entry in patient records within HCHB
• Maintain payor files with up-to-date requirements to obtain/initiate appeals for denied authorizations
• Interface with contract, clinical, and office staff to foster collaboration and positive working relationships
• Prepare patient co-pay estimates and notify scheduling of authorized visits
• Provide excellent customer service to patients, referral sources, and community contacts with questions regarding payor prior authorizations and medical guidelines
• Enter, 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:

• Customer Second (Employee First!)
• Accountability
• Passion for Learning
• Love One Another
• Intelligent Risk Taking
• Celebration
• Ownership

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.