Insurance Authorization Coordinator

Pennant Group; United States; Remote; USD 45,000 - 65,000; Full time

Job summary

The Pennant Group, Inc. is seeking an Insurance Authorization Coordinator for their Home Health and Hospice division. You will manage payer authorizations ensuring timely coverage from admission to discharge.

The role requires deep knowledge of Medicare/Medicaid, and strong collaboration with scheduling and clinical teams to verify eligibility and secure approvals. Candidates with 3+ years in insurance verification and a healthcare administration background are encouraged to apply.

Qualifications

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

Responsibilities

• Oversee timely submission and tracking of initial insurance authorizations for home health and hospice.
• Coordinate with scheduling teams to ensure services start after authorization.
• Lead add-on authorizations for plan changes and manage eligibility re-verification monthly.

Skills

Insurance verification

Authorization knowledge

Attention to detail

Education

Associate’s or Bachelor’s degree in Business, Finance, Healthcare Administration, or related field

Tools

EMR systems

Authorization tracking software

Job description

Insurance Authorization Coordinator-Home Health and Hospice

Join Pennant’s dynamicinsurance authorizationteam asthe Insurance Authorization Coordinator! We are looking for an exceptional team player toorchestratethe crucial function of securingtimelyandaccurateinsurance authorizations for our patients. Yourexpertisewill be key to ensuring uninterrupted care andoptimizingour financial health.

About the Role

You 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 Responsibilities

• Initial Authorization: Oversee thetimelyandaccuratesubmission and tracking of all initialinsurance authorization requests for home health andhospicepatients.

• Collaboration and Communication: Work closely and effectivelywith 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 the485 (Plan of Care)submission and managing all add-on insurance authorizations whenrequiredfor changes in the patient’s plan of care (e.g., increased visits, new services).

• Ongoing Eligibility Management: Establishand monitor the process for the team to re-verify eligibility on the 1st and 5th of each month for all active patients to proactivelyidentifyand resolve any changes in insurance status.

• Payer Relations: Serve as the escalation point for complexauthorizationdenials 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.

Qualifications

Required:

• 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.

• Proficiencyin using electronic medical record (EMR) systems and authorization tracking software.

Preferred:

• Associate’sorBachelor’s degree in Business, Finance, Healthcare Administration, ora relatedfield.

• Experience withutilizationreview andappealsprocesses.

Skills and Competencies

• Superior analytical and organizational skills withan unwaveringattention 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,

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.