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.

How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
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