Insurance Authorization Lead — Home Health & Hospice

Deercreekseniorliving; Nashville (TN); On-site; USD 42,000 - 62,000; Full time

Job summary

The Pennant Group, Inc. is seeking an Insurance Authorization Coordinator for its home health and hospice operations in the United States.

The role ensures timely authorizations from admission through discharge, collaborating with scheduling and clinical teams to safeguard uninterrupted patient care. Responsibilities include managing 485 Plan of Care authorizations, add-ons, monthly eligibility checks, and handling complex denial issues with carriers.

Qualifications

• 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.

Responsibilities

• Oversee the timely and accurate submission and tracking of all initial insurance authorization requests for home health and hospice patients.
• Coordinate start of care with scheduling teams to ensure services are delivered after authorization.
• Direct the process for 485 (Plan of Care) submission and managing add-on authorizations when required.
• Establish and monitor the process to re-verify eligibility on the 1st and 5th of each month for all active patients.
• Serve as the escalation point for complex authorization denials or issues with insurance carriers.
• Generate reports on authorization status, denial rates, and turnaround times.

Skills

EMR systems

Authorization tracking

Attention to detail

Interpersonal communication

Education

Business/Finance/Healthcare Admin degree

Job description

The Pennant Group, Inc. is seeking an Insurance Authorization Coordinator for its home health and hospice operations in the United States.

The role ensures timely authorizations from admission through discharge, collaborating with scheduling and clinical teams to safeguard uninterrupted patient care. Responsibilities include managing 485 Plan of Care authorizations, add-ons, monthly eligibility checks, and handling complex denial issues with carriers.