Onsite Home Health Prior Authorization Specialist

Human Touch Home Care; Washington (District of Columbia); On-site; USD 65,904,000 - 74,501,000; Full time

Benefits offered by this job

Health insurance

Vision

Dental

Paid Time Off

Sick Leave

Retirement plans

Job summary

Human Touch Home Care seeks an experienced Home Health Prior Authorization Specialist to manage the authorization process for patients receiving home health services. The role focuses on obtaining initial and continued authorizations, verifying eligibility and benefits, and submitting required clinical documentation.

This onsite, DC-based position requires knowledge of Medicaid, Medicare Advantage, payer portals, and home health documentation.

Qualifications

• 2+ years of experience in medical insurance authorization or related healthcare admin role.
• Home health authorization experience preferred.
• Experience with Medicare Advantage, Medicaid, and managed care.
• Knowledge of home health services and authorization requirements.
• Experience using payer portals and EMR systems.
• Strong communication, organization and attention to detail.

Responsibilities

• Obtain prior authorizations for home health services.
• Verify patient insurance eligibility, benefits, coverage and requirements.
• Submit initial authorization requests to payers and managed care orgs.
• Submit requests for continued services and additional visits when necessary.
• Maintain authorization records and monitor expiration dates.
• Communicate authorization decisions to clinical and administrative teams.
• Escalate urgent authorization issues affecting patient care.

Skills

Attention to detail

Communication skills

Time management

HIPAA compliance

Payer portals experience

Education

High school diploma or GED

Tools

EMR systems

Payer portals

Job description

Human Touch Home Care seeks an experienced Home Health Prior Authorization Specialist to manage the authorization process for patients receiving home health services. The role focuses on obtaining initial and continued authorizations, verifying eligibility and benefits, and submitting required clinical documentation.

This onsite, DC-based position requires knowledge of Medicaid, Medicare Advantage, payer portals, and home health documentation.