Remote Home Health Authorization Specialist

COMFORT HOME HEALTH LLC; Falls Church (VA); On-site; USD 55,000 - 70,000; Full time

Benefits offered by this job

401(k)

Competitive salary

Training & development

Job summary

VitalCare Home Health LLC is seeking an experienced Authorization Specialist to join our growing Home Health team. The Authorization Specialist is responsible for obtaining, tracking, and managing insurance authorizations for skilled nursing and private duty nursing services.

This role collaborates with physicians, case managers, Medicaid managed care organizations, clinical staff, and families to ensure timely approvals and uninterrupted patient care. Flexible remote work options are available.

Qualifications

• Minimum 2 years of Home Health authorization experience.
• Experience with Virginia Medicaid and Managed Care Organizations.
• Strong knowledge of authorization processes.
• Excellent organizational and communication skills.
• Ability to manage multiple authorizations simultaneously.
• Strong computer skills and attention to detail.

Responsibilities

• Submit initial and continued authorization requests.
• Track authorization expiration dates and renewals.
• Verify Medicaid and insurance eligibility.
• Communicate with MCOs regarding authorization status.
• Coordinate with physicians to obtain required documentation.
• Review nursing assessments and physician orders for completeness.
• Monitor pending authorizations and prevent delays.
• Resolve authorization denials and submit additional documentation when required.
• Maintain documentation in Alora Plus EMR.
• Collaborate with Intake, Clinical Managers, and Scheduling staff.
• Maintain HIPAA compliance and confidentiality.

Skills

Prior Authorization

Home Health

Medicaid

Insurance Verification

Medical Documentation

HIPAA

Customer Service

Communication

Time Management

Attention to Detail

Problem Solving

Tools

Alora Plus EMR

Microsoft Office

Job description

VitalCare Home Health LLC is seeking an experienced Authorization Specialist to join our growing Home Health team. The Authorization Specialist is responsible for obtaining, tracking, and managing insurance authorizations for skilled nursing and private duty nursing services.

This role collaborates with physicians, case managers, Medicaid managed care organizations, clinical staff, and families to ensure timely approvals and uninterrupted patient care. Flexible remote work options are available.