Remote Insurance Verification & Authorization Coordinator

Graham Healthcare Group; Northern (KY); Hybrid; USD 51,577,000 - 63,039,000; Full time

Benefits offered by this job

Health benefits

401(k) plan

PTO

Tuition programs

Job summary

Graham Healthcare Group is seeking an Insurance Verification & Authorization Coordinator to work remotely for a nationwide team. You will obtain benefit information, verify authorizations, and coordinate with clinical staff to ensure timely patient care across Home Health lines.

Required: 1+ year in insurance verification or medical billing, MS Office proficiency, Medicare/Medicaid knowledge. Benefits include medical, 401k, PTO, and tuition programs.

Qualifications

• Associate degree or combination of experience and business courses preferred.
• Minimum of one (1) year of previous experience in insurance verification, authorization, or medical billing.
• Proficiency in Microsoft Office Suite.
• Knowledge of Medicare, Medicaid, and third‑party insurance and authorization requirements.
• Knowledge of insurance websites.
• Knowledge of HomeCare Homebase preferred.
• Conscientious, with attention to detail.
• Demonstrated patience, flexibility, and cooperative attitude.
• Ability to think critically and act independently when resolving benefit discrepancies.
• Effective verbal and written communication skills with others both internally and externally.
• Ability to work independently and within a multidisciplinary team.
• Availability weekends, holidays, and after hours based on business needs.

Responsibilities

• Obtain detailed and accurate benefit information using payer portals, phone, or fax for all insurance companies accepted by Home Health product lines.
• Validate and document all payor information such as patient name, DOB, and policy number in the EMR.
• Reduce write-offs by clearly documenting benefit information such as deductibles, co pays, co‑insurance, and out‑of‑pocket maximums in the patients’ charts through coordination notes.
• Continuously monitor task flow screen related to all insurance issues including Medicare eligibility, follow up to on‑call completed insurance, and re‑verify insurance at recertification.
• Review entitlement verification reports daily, researching any questionable answers.
• Review problems related to all insurance changes daily.
• Review of funding source updates daily.
• Reverify current Medicaid patients to monitor HMO status monthly.
• Reverify current patients’ insurances monthly to monitor for any payer changes or other agencies monthly.
• Contact patients, hospitals, or physician offices for information or to clarify benefit.
• Assist scheduling with funding source problems related to scheduling out visits to clinical staff.
• Reduce write-offs by working with the clinical staff to ensure transfer of agency/provider of choice forms are received and sent timely.
• Obtain detailed and accurate authorization, prior authorization, and ongoing authorization as required by insurance companies via phone, fax, or payer portal.
• Understand and maintain the authorization tab in HCHB.
• Provide clinical information as requested by insurance companies.
• Notify internal clinical staff of authorization approvals and denials.
• Monitor authorization issues including reauthorization for new orders and updating pending authorization.

Skills

MS Office

Homecare Homebase

Verbal & written communication

Attention to detail

Critical thinking

Education

Associate degree

Tools

Homecare Homebase

Job description

Graham Healthcare Group is seeking an Insurance Verification & Authorization Coordinator to work remotely for a nationwide team. You will obtain benefit information, verify authorizations, and coordinate with clinical staff to ensure timely patient care across Home Health lines.

Required: 1+ year in insurance verification or medical billing, MS Office proficiency, Medicare/Medicaid knowledge. Benefits include medical, 401k, PTO, and tuition programs.