Remote Health Insurance Authorization Specialist

Centerwell; United States; On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Comprehensive benefits

Job summary

Centerwell is seeking a full‑time remote Revenue Cycle professional to oversee documentation audit, eligibility verification, and billing processes. You will generate weekly revenue reports and coordinate with sites on issues affecting revenue.

Strong knowledge of insurance reimbursement and authorization processes is required, along with proficiency in Microsoft Office. The role emphasizes accurate billing, compliance with Medicare/Medicaid guidelines, and collaboration with AR teams.

Qualifications

• One or more years of related experience preferred.
• Two or more years in Home Healthcare or Medical Office experience preferred.
• Knowledge of insurance reimbursement and authorization process preferred.
• Proficient in Microsoft Office applications (Word, Excel, Outlook) and general computer usage.

Responsibilities

• Daily audit of admission, discharge, and other source documentation to ensure revenue is recognized appropriately and all conditions of payment are met.
• Verify patient eligibility and payor coverage guidelines to ensure that all necessary information is secured for timely, accurate revenue recognition.
• Generate weekly site revenue reports and resolve batch errors and bill holds as appropriate.
• Communicate weekly with site leadership regarding outstanding documentation or issues that could result in potential revenue loss.
• Prepare and submit invoices to Accounts Payable for reimbursement, and follow up to ensure accurate, timely payments to facility partners.
• Prepare, submit, and follow up on authorization and re‑authorization requests according to applicable state and commercial payor guidelines.
• Coordinate, review, and analyze documentation and data entry supporting Medicare, Medicaid, and commercial payer requirements to ensure accurate and timely billing.
• Implement and follow all internal controls and related policies/procedures in accordance with accounts‑receivable requirements.
• Meet all payer requirements, including pre‑certification, notification, and level‑of‑care change documentation.
• Alert appropriate team members at the site regarding late or missing documents required for billing.
• Establish and maintain positive working relationships with sites, nursing home facilities, and AR teams.
• Maintain confidentiality of patient/client and agency information.
• Maintain accurate, up‑to‑date information for all vendor and nursing facility contracts.
• Keep information in an orderly, readily accessible manner for review and present status as requested.
• Ensure compliance with local, state and federal laws, Medicare regulations, and company policies and procedures.
• Participate in special projects and perform other duties as assigned.
• Assist in training newly‑hired associates and re‑education of revenue teams as needed.
• Provide information resources for hard revenue generation or system issues, acting as subject‑matter expert.
• Coordinate completion of work in an associate's absence to maintain departmental standards.

Skills

Experience in Home Healthcare

Medical Office experience

Tools

Microsoft Office

Job description

Centerwell is seeking a full‑time remote Revenue Cycle professional to oversee documentation audit, eligibility verification, and billing processes. You will generate weekly revenue reports and coordinate with sites on issues affecting revenue.

Strong knowledge of insurance reimbursement and authorization processes is required, along with proficiency in Microsoft Office. The role emphasizes accurate billing, compliance with Medicare/Medicaid guidelines, and collaboration with AR teams.