Weekend Managed Care Coordinator

Covenant Care, Corp.; Jacksonville, Northern (FL, KY); Hybrid; USD 2,755,000 - 3,857,000; Part time

Job summary

Concierge Home Care is seeking a Managed Care Coordinator to verify insurance benefits, obtain authorizations, and maintain payer information in an EMR. You will collaborate with Intake, Operations, Sales, and referral sources to ensure timely access to home health services.

The role requires attention to detail, strong follow-through, and experience with insurance portals and EMR systems. This is a PRN, weekends role with remote Florida residence eligibility.

Qualifications

• Some college and 2+ years of experience obtaining medical insurance authorizations.
• Experience with eligibility and benefit verification.
• Experience communicating with insurance companies and managed care organizations.
• Experience navigating insurance portals and authorization systems.
• Experience using an EMR or electronic health records system.
• Strong attention to detail and accuracy.
• Excellent organizational and follow-through skills.
• Ability to manage multiple authorization requests and deadlines.

Responsibilities

• Verify daily insurance eligibility and benefits for new and existing patients.
• Review patient information and identify payer requirements.
• Obtain initial authorizations and monitor status/expiration dates.
• Obtain reauthorizations as required to support continued patient care.
• Document authorization information in the EMR and maintain records.
• Communicate with insurance companies and payer representatives; navigate portals.
• Collaborate with Intake, Operations, Sales, and referrals on payer needs.
• Escalate authorization concerns and resolve issues promptly.

Skills

Attention to detail

Organizational skills

Communication skills

Education

Some college

Tools

EMR systems

Insurance portals

EMR platforms

Job description

Concierge Home Care | Remote-Florida Residence

PRN | EVERY Saturdays & Sundays | 8:30 AM to 5:00 PM

Managed Care & Authorization Focus

Help Patients Access the Care They Need

At Concierge Home Care, we believe in the power of home health care to change lives—for patients and team members alike. Our mission, “Caring for people who care for people,” drives everything we do.

As a Managed Care Coordinator, you will play a critical role in helping patients receive the home health services they need by ensuring insurance benefits are verified, authorizations are obtained, and required payer processes are completed accurately and on time.

This position is part of our Intake Department and works closely with Operations, Sales, referral sources, and insurance payors.

Why Team Members Choose Concierge Home Care

Meaningful Work

• Help ensure patients have timely access to home health services
• Play an important role in the coordination of patient care
• Work collaboratively with Operations, Sales, Intake, providers, and payors
• Be part of a growing healthcare organization focused on quality patient care

Professional Growth

• Structured onboarding and training
• Exposure to multiple insurance plans and managed care processes
• Opportunities to develop expertise in healthcare authorizations and payer relations
• Opportunities for professional growth within Intake and Operations
• Supportive leadership and collaborative team environment

Your Role as a Managed Care Coordinator

The Managed Care Coordinator is responsible for managing the insurance verification and authorization process for new and existing home health patients.

Success in this role requires strong attention to detail, excellent follow-through, and a thorough understanding of insurance authorization processes. You will help ensure that authorization requirements are identified, completed, documented, and maintained throughout the patient's episode of care.

Responsibilities Include

Insurance Verification & Eligibility

• Complete daily insurance eligibility and benefit verification for new and existing patients
• Review patient insurance information and identify payer requirements
• Verify coverage, benefits, limitations, and authorization requirements
• Monitor and reconcile insurance changes
• Maintain accurate payer and patient information within the EMR

Authorization & Reauthorization

• Obtain initial authorizations for home health services
• Monitor authorization status and expiration dates
• Obtain reauthorizations as required to support continued patient care
• Follow up with insurance companies and managed care organizations regarding pending authorizations
• Ensure authorization information is accurately documented within the EMR
• Maintain a consistent process to prevent authorization gaps
• Communicate directly with insurance companies, managed care organizations, and payer representatives
• Navigate payer portals and electronic authorization systems
• Submit required documentation and information to support authorization requests
• Follow up on outstanding requests and resolve authorization-related issues
• Maintain professional relationships with payer representatives

Documentation & Compliance

• Maintain accurate and complete records of eligibility, benefits, authorizations, and reauthorizations
• Ensure payer requirements and authorization information are documented appropriately
• Protect confidential patient and insurance information in accordance with HIPAA regulations
• Follow company policies and established managed care processes

Internal Collaboration

• Collaborate with the Intake team to support timely referral processing
• Partner with Operations regarding authorization requirements and patient status
• Communicate with Sales and referral sources when payer information or authorization requirements impact patient acceptance
• Escalate authorization concerns or potential coverage issues appropriately

Our Managed Care team works with multiple electronic systems and payer platforms, including:

• Electronic Medical Record (EMR) systems
• Insurance verification platforms
• Electronic authorization systems
• Healthcare referral and documentation platforms

Experience navigating multiple EMR systems and insurance portals is highly preferred.

Qualifications

Required

• Some college
• Minimum 2 years of recent experience obtaining medical insurance authorizations
• Experience with insurance eligibility and benefit verification
• Experience communicating with insurance companies and managed care organizations
• Experience navigating insurance portals and authorization systems
• Experience working with an EMR or electronic healthcare documentation system
• Strong attention to detail and accuracy
• Excellent organizational and follow-through skills
• Ability to manage multiple authorization requests and deadlines simultaneously
• Strong written and verbal communication skills
• Ability to work collaboratively with multiple departments
• Ability to maintain patient confidentiality and follow HIPAA requirements

Preferred

• Experience in home health, hospice, healthcare, or another post-acute setting
• Knowledge of home health insurance authorization and reauthorization processes
• Familiarity with medical terminology
• Experience working with multiple EMR platforms
• Experience working with Medicare Advantage, managed care, Medicaid, commercial insurance, or other healthcare payors
• Experience working in a high-volume Intake or Managed Care environment

Join a Team That Cares

At Concierge Home Care, our mission is simple: “Caring for people who care for people.”

We believe great patient care starts with great team members. If you are experienced in insurance authorizations, eligibility, managed care, and payer communication and want to use those skills to help patients access the care they need, we would love to meet you.