Insurance Verification & Authorization Specialist
VitalCaring Group
full-time
Posted on:
Location Type: Remote
Location: Alabama • Florida • United States
Visit company websiteExplore more
About the role
- 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
Requirements
- High school diploma or equivalent required; associate degree or higher preferred.
- Minimum 2 years of experience in home health authorization/eligibility processes.
- Proficiency in Homecare Homebase (HCHB) strongly preferred.
- Strong understanding of traditional Medicare, Medicare Advantage, and commercial insurance guidelines.
- Experience navigating payer websites/portals (e.g., Availity, Waystar, Palmetto etc.).
- Detail-oriented with excellent organizational and follow-up skills.
- Effective communication and customer service skills with both internal teams and external payers.
- Ability to multitask in a high-volume, fast-paced remote or office environment.
Benefits
- Medical, Dental & Vision
- Pharmacy Benefits
- Virtual & Mental Health Support
- Flexible Spending Accounts (FSAs) & Health Savings Account (HSA)
- Supplemental Health & Life Insurance
- 401(k) with Company Match
- Employee Referral Program
- Prepaid Legal Plans
- Identity Theft Protection
- Paid Time Off
- Pet Insurance
- Tuition & Continuing Education Reimbursement
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
insurance verificationprior authorizationsdata entryeligibility information managementpayer protocolsdocumentation requirementscompliance standardsauthorization processingappeals managementhome health services
Soft Skills
detail-orientedorganizational skillsfollow-up skillseffective communicationcustomer servicecollaborationmultitaskingproblem-solvingtime managementadaptability