Insurance Authorization Coordinator

The Pennant Group; Eagle (ID); On-site; USD 45,000 - 65,000; Full time

Job summary

The Pennant Group is seeking an Insurance Authorization Coordinator to join our home health and hospice services team. You will oversee initial authorizations, manage add-ons, and ensure timely coverage from admission to discharge, enabling uninterrupted patient care.

Collaborating with scheduling and clinical staff, you will verify eligibility, handle complex denials, and generate regular reports on turnaround times and denial rates, while ensuring compliance with payer contracts.

Qualifications

• Minimum of 3 years in insurance verification and authorization in Home Health or Hospice.
• Expert knowledge of Medicare, Medicaid, and commercial insurance authorization processes.
• Experience with EMR systems and authorization tracking software.

Responsibilities

• Oversee initial insurance authorization submissions and tracking.
• Coordinate start of care with scheduling teams after authorization.
• Manage 485 and add-on authorizations for plan changes.
• Re-verify eligibility on the 1st and 5th of each month.
• Escalate complex denials and communicate with insurance carriers.
• Generate reports on authorization status, denial rates, and turnaround times.

Skills

Analytical skills

Organizational skills

Interpersonal skills

Team leadership

Regulatory compliance

Education

Business/Healthcare degree

Tools

EMR systems

Authorization tracking software

Job description

Insurance Authorization Coordinator- Home Health and HospiceJoin Pennant’s dynamic insurance authorization team as the Insurance Authorization Coordinator! We are looking for an exceptional team player to orchestrate the crucial function of securing timely and accurate insurance authorizations for our patients. Your expertise will be key to ensuring uninterrupted care and optimizing our financial health.About the RoleYou will be responsible for all aspects of payer authorization. This role demands deep knowledge of payer requirements, strong ownership skills, and meticulous attention to detail to ensure every patient's services are appropriately covered from admission through discharge.Key ResponsibilitiesInitial Authorization: Oversee the timely and accurate submission and tracking of all initial insurance authorization requests for home health and hospice patients.Collaboration and Communication: Work closely and effectively with the scheduling teams to coordinate start of care and ensure clinical services are only delivered after authorization is confirmed.485 and Add-On Authorization: Direct the process for obtaining authorization following the 485 (Plan of Care) submission and managing all add-on insurance authorizations when required for changes in the patient's plan of care (e.g., increased visits, new services).Ongoing Eligibility Management: Establish and monitor the process for the team to re-verify eligibility on the 1st and 5th of each month for all active patients to proactively identify and resolve any changes in insurance status.Payer Relations: Serve as the escalation point for complex authorization denials or issues, communicating directly with various insurance carriers.Compliance and Reporting: Ensure all authorization processes are compliant with payer contracts and regulatory standards. Generate reports on authorization status, denial rates, and turnaround times.QualificationsRequired:Minimum of 3 years of dedicated experience in insurance verification and authorization, specifically within Home Health or Hospice.Expert knowledge of Medicare, Medicaid, and commercial insurance authorization processes and documentation requirements for episodic and per diem payments.Proficiency in using electronic medical record (EMR) systems and authorization tracking software.Preferred:Associate's or Bachelor's degree in Business, Finance, Healthcare Administration, or a related field.Experience with utilization review and appeals processes.Skills and CompetenciesSuperior analytical and organizational skills with an unwavering attention to detail.Exceptional ability to navigate complex payer portals and communication channels.Excellent interpersonal skills for effective collaboration with clinical and scheduling staff.Proven ability to lead a team in a high-volume, deadline-driven environment.Strong commitment to regulatory compliance and ethical billing practices.If you are a results-oriented authorization expert ready to lead a critical function that ensures our patients receive the care they need, apply today!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.