Insurance & Authorization Coordinator
Core
Verify patient insurance eligibility, obtain authorizations, and manage funding sources to ensure accurate billing and care continuity in home health.
Role type
Healthcare operations coordinator (insurance & authorization)
Builds
Accurate patient funding records and authorization workflows for home health agencies
Domain
Healthcare administration / Insurance verification
Deliverable
Dashboards & analysis
Required skills
Insurance verification, Prior authorization, Payer portal navigation, Medicare/Medicaid knowledge, Data entry, Discrepancy investigation, Patient communication, Provider coordination, Billing support, Documentation compliance
Preferred skills
Homecare Homebase (HCHB) experience, Associate degree, Microsoft Office proficiency
Responsibilities
Obtain insurance benefit information via portals, phone, and fax; Verify and document patient/policy details in electronic medical records; Monitor daily insurance workflows and eligibility alerts; Investigate inconsistent eligibility results; Resolve funding-source update issues; Contact patients and providers for missing information; Support scheduling teams with funding issues; Coordinate provider transfer documentation; Obtain and maintain authorization records; Follow up on authorization submissions and denials; Support billing team with verification discrepancies; Maintain knowledge of payer requirements and procedures.
Seniority
Individual Contributor, entry-to-mid level
