Insurance & Authorization Coordinator

Accountabilities:

• Obtain detailed and accurate insurance benefit information through payer portals, phone calls, and fax for accepted home health insurance plans.
• Verify and document patient and policy information, including patient name, date of birth, policy numbers, eligibility, deductibles, copayments, coinsurance, and out-of-pocket maximums within the electronic medical record.
• Monitor daily insurance-related workflows, including Medicare eligibility verification, completed insurance follow-ups, eligibility alerts, initial verifications, recertifications, resumption of care, and other insurance-related tasks.
• Review entitlement verification reports and investigate questionable or inconsistent eligibility results.
• Monitor and resolve insurance changes and funding-source update issues, including monthly Medicaid and HMO status reviews and recurring checks for payer or agency changes.
• Contact patients, hospitals, physician offices, and other relevant parties to obtain missing information or clarify benefit details.
• Support scheduling teams when funding-source issues affect the ability to schedule visits with clinical staff.
• Coordinate provider or agency transfer documentation within required timeframes to help minimize avoidable write-offs.
• Obtain initial, prior, and ongoing authorizations as required by payers through phone, fax, or payer portals, and maintain accurate authorization information in the electronic medical record.
• Provide requested clinical information to insurance companies and follow up on authorization submissions, additional documentation requests, approvals, and denials.
• Monitor authorization workflows for new orders, initial authorizations, reauthorizations, pending requests, and updates to approved authorization information.
• Support the billing team by researching insurance verification or authorization discrepancies that could delay claim submission.
• Develop and maintain strong working knowledge of payer portals, insurance requirements, and authorization processes.
• Maintain accurate records and comply with applicable procedures, quality expectations, and organizational standards.
• Perform additional duties and support other operational needs as assigned.

Requirements:

• Associate degree or a combination of relevant professional experience and business coursework is preferred.
• At least 1 year of experience in insurance verification, authorization, medical billing, or a closely related healthcare administrative function.
• Knowledge of Medicare, Medicaid, third-party insurance, and payer authorization requirements.
• Familiarity with insurance websites and payer portals, with the ability to learn and navigate multiple systems efficiently.
• Homecare Homebase (HCHB) experience is strongly preferred.
• Proficiency with Microsoft Office Suite and the ability to work comfortably with electronic records and administrative systems.
• Strong attention to detail and a conscientious approach to documenting sensitive and financially important information.
• Patience, flexibility, and a cooperative attitude when working with patients, providers, payers, and internal teams.
• Ability to think critically, investigate discrepancies, and work independently toward appropriate resolutions.
• Effective written and verbal communication skills for working with both internal and external stakeholders.
• Ability to work independently while contributing effectively within a multidisciplinary healthcare team.
• Willingness to work every other Saturday, as well as occasional weekends, holidays, or after-hours schedules based on business needs.
• Must live in the Central Time Zone to be considered for this position.
• Must be legally authorized to work in the United States.

Benefits:

• Fully remote position, with a full-time schedule of 40 hours per week.
• Monday–Friday schedule, generally 8:30 AM–5:00 PM Central Time, with every-other-Saturday availability required.
• Compensation of $18.00–$22.00 per hour, with a fixed maximum of $22.00 per hour.
• Medical, dental, and vision insurance options.
• 401(k) retirement plan and pension with a 4% employer contribution.
• 15 days of paid time off.
• Company-paid life insurance and disability benefits.
• Flexible Spending Account (FSA) and Health Savings Account (HSA) options.
• Education support, including 50% tuition discounts for selected courses through Purdue and Kaplan.
• Opportunities for career development and advancement.
• Benefits may vary based on employment status.