American Nurses Homecare has served Central Florida for more than 26 years. We are seeking a detail-oriented, organized, and proactive Home Care Authorization Coordinator to join our Medicare-certified home health agency in Orlando, Florida.
This position is responsible for obtaining, tracking, and maintaining insurance authorizations for a high volume of home health patients. The Authorization Coordinator will work closely with Intake, Clinical, Staffing, Billing, physicians’ offices, and insurance companies to help prevent delays or interruptions in patient care.
This is a fast-paced position requiring strong follow-up, attention to detail, and the ability to manage multiple deadlines and priorities.
Key Responsibilities
- Submit initial, concurrent, and renewal authorization requests to insurance companies.
- Track authorizations for nursing, therapy, Home Health Aide (HHA), and other approved home health services.
- Verify authorization dates, approved services, frequencies, hours, visits, and units.
- Monitor authorization expiration dates and submit renewal requests before coverage expires.
- Review patient records to confirm that the required orders and clinical documentation are available.
- Gather and submit supporting documents, including physician orders, Plans of Care, clinical notes, OASIS assessments, and other required records.
- Communicate with insurance companies, case managers, utilization-review departments, and provider portals.
- Follow up frequently on pending authorization requests.
- Respond promptly to requests for additional clinical documentation.
- Review authorization approvals and enter information accurately into the agency’s EMR system.
- Upload authorization documents and maintain organized, accurate, and current patient records.
- Notify Intake, Clinical, Staffing, and Billing when authorizations are approved, modified, denied, or delayed.
- Alert the appropriate departments before an authorization expires or when approved services are running low.
- Compare scheduled and provided services against approved authorizations.
- Help prevent unauthorized visits, service interruptions, and billing issues.
- Assist with authorization corrections, reconsiderations, and appeals when necessary.
- Document all calls, portal submissions, follow-up efforts, and authorization updates.
- Answer calls and communicate professionally with patients, caregivers, insurance representatives, physicians’ offices, and agency staff.
- Escalate urgent authorization problems or potential interruptions in patient care to management.
- Maintain patient confidentiality and follow HIPAA requirements.
- Perform other authorization and home care coordination duties as assigned.
Qualifications
- Previous experience with healthcare authorizations, utilization management, insurance verification, medical referrals, or home health is strongly preferred.
- Familiarity with Medicare-certified home health services is preferred.
- Knowledge of managed-care plans, authorization requirements, and insurance portals is preferred.
- Understanding of home health orders, Plans of Care, OASIS documentation, and clinical records is a plus.
- Ability to manage a high volume of patients, authorization requests, and deadlines.
- Strong organizational, multitasking, and follow-up skills.
- Excellent attention to detail and data-entry accuracy.
- Strong written and verbal communication skills.
- Professional telephone etiquette and customer service skills.
- Comfortable using computers, email, electronic medical records, fax systems, and payer portals.
- Ability to work independently and collaboratively in a fast-paced environment.
- Ability to handle confidential patient information professionally.
- Bilingual in English and Spanish is preferred.
Pay: $15.00 - $17.00 per hour
Benefits:
Work Location: In person
