VitalCaring Group

Administration

• Lead and manage all referral portal platforms: maintaining configurations, service line rules, coverage areas, payor matrices, and branding.
• Ensure listing accuracy across all hospital and third-party portals by partnering with Intake, RCM, and Operations.
• Grant and manage user access & permissions while ensuring consistent workflows and communication.
• Build and deliver dashboards and reports that track referral volume, acceptance trends, response times, conversion rates, and leakage opportunities.
• Spot and solve barriers in partnership with Sales, Intake, IT, and Operations—removing roadblocks and improving workflows.
• Provide hands-on support for the Sales and Intake teams for troubleshooting, updates, and portal optimization needs.
• Drive automation and AI-supported workflows by partnering with IT and cross-functional teams.
• Maintain portal documentation including requirements, contacts, and best practices.
• Reduce manual effort through smarter configuration, standardized processes, and continuous improvement.
• Support accuracy of sales-related data in CRM, EMR, and related systems.

Sales Portal Administrator

Insurance

• Conduct insurance verification through payer portals, phone calls, and HCHB’s integrated tools for all new referrals and ongoing patients.
• Initiate and obtain prior authorizations for home health services including nursing, therapy, and aide services as required by payers.
• Accurately enter and maintain insurance, authorization, and eligibility information within the HCHB system in real-time.
• Review patient intake information to ensure payer requirements are identified and addressed early in the admission process.
• Collaborate with intake, clinical staff, case managers, and billing teams to resolve authorization-related issues promptly
• Follow up proactively with insurance companies to ensure timely processing of authorizations and appeals.
• Stay current on payer-specific authorization protocols, documentation requirements, and changes to coverage policies affecting home health.
• Ensure compliance with HIPAA, Medicare Conditions of Participation, and other regulatory standards.
• Maintain organized and auditable records of all insurance and authorization communications and decisions within HCHB and agency systems

Sales Portal Administrator

Insurance Verification & Authorization Specialist