In-Home Care Insurance Authorization Specialist

AccentCare, Inc.; Los Angeles (CA); On-site; USD 30,000 - 34,000; Full time

Benefits offered by this job

Medical coverage

Paid time off

Professional development

401(k) matching

Flexible spending accounts

AccentCare scrubs

Job summary

AccentCare, Inc. is hiring an Insurance Authorization Specialist to verify insurance coverage, submit and follow up on authorizations for in-home services, and ensure timely payment.

The role involves clinical information gathering, EMR data entry, and coordination with payor case managers and branch teams. Requirements include at least a high school diploma and 1+ years in home healthcare or with insurance payors.

Qualifications

• Insurance authorization experience preferred.
• Experience with insurance payors, portals & guidelines is desirable.
• Familiarity with HIPAA and documentation standards.

Responsibilities

• Verifies insurance coverage and ensures accuracy per procedures and job aids.
• Submits, follows up, and conducts clinical review for in-home services to secure payment.
• Obtains clinical information from payors or branch staff for authorization consideration.
• Contacts payors to verify coverage, benefits and patient financial responsibility at start of care or recertification.
• Enters authorization information into EMR after authorization/denial is obtained.
• Monitors and completes electronic workflow and coordinates with Operations and Sales to resolve authorization issues.
• Communicates with branch teams to resolve eligibility or authorization concerns.
• Follows up on outstanding verifications or authorizations to ensure resolution.
• Complies with HIPAA, Code of Conduct, and other regulatory requirements.

Education

High school diploma or equivalent

Job description

AccentCare, Inc. is hiring an Insurance Authorization Specialist to verify insurance coverage, submit and follow up on authorizations for in-home services, and ensure timely payment.

The role involves clinical information gathering, EMR data entry, and coordination with payor case managers and branch teams. Requirements include at least a high school diploma and 1+ years in home healthcare or with insurance payors.