Intake & Authorizations Specialist
Hybrid, Full-Time, Monday – Friday position (Las Vegas, Nevada Location)
About Us:
Trusted Ally Home Care (TAHC) is a growing multi-state home care agency that specializes in providing nursing and home health aide services to nuclear-exposed employees in the comfort of their homes. TAHC has been serving families and loved ones since 2010. After witnessing the impact that quality home care services brought to her great-grandfather's life, our co-founder Candace Honeywell, was determined to bring the same level of care to everyone we serve. Together, with co-founder Alexander Page, they are committed to driving positive change in home health care.
Core Values
Role Overview
The Specialist initiates the intake process by reviewing and validating all incoming referrals to ensure eligibility under the EEOICPA program. This includes confirming white card status, ICD codes, treating physician assignment, AR involvement, and required demographic and clinical data. Once verified, the Specialist inputs referral information into internal systems, flags missing documents, and initiates the patient record in accordance with agency protocols. They collaborate with Business Development and Clinical staff to ensure timely follow-up, accurate documentation, and appropriate scheduling for TP visits. Specialists are also responsible for tracking referral status and communicating updates to stakeholders across departments. Timely and thorough intake processing directly impacts patient access to care, authorization readiness, and billing accuracy. Specialists must also remain vigilant for red flags such as incomplete AR paperwork or missing consent forms that could delay onboarding. This function requires attention to detail, regulatory awareness, and collaboration across teams to move patients smoothly through the intake pipeline.
5 Major Job Functions:
1. Referral Intake Processing and Data Verification
2. Authorization File Preparation and Documentation Coordination
3. LOMN and Development Drafting Support
4. DME Tracking and Care Planning Integration
5. Communication, Training Support, and Cross-Departmental Engagement
1. Referral Intake Processing and Data Verification
The Specialist initiates the intake process by reviewing and validating all incoming referrals to ensure eligibility under the EEOICPA program. This includes confirming white card status, ICD codes, treating physician assignment, AR involvement, and required demographic and clinical data. Once verified, the Specialist inputs referral information into internal systems, flags missing documents, and initiates the patient record in accordance with agency protocols. They collaborate with Business Development and Clinical staff to ensure timely follow-up, accurate documentation, and appropriate scheduling for TP visits. Specialists are also responsible for tracking referral status and communicating updates to stakeholders across departments. Timely and thorough intake processing directly impacts patient access to care, authorization readiness, and billing accuracy. Specialists must also remain vigilant for red flags such as incomplete AR paperwork or missing consent forms that could delay onboarding. This function requires attention to detail, regulatory awareness, and collaboration across teams to move patients smoothly through the intake pipeline.
2. Authorization File Preparation and Documentation Coordination
Specialists are responsible for assembling complete and compliant documentation packets to support all types of authorizations: initials, reauthorizations, increases, and appeals. Each packet must include required elements such as Plans of Care, LOMNs, testing results, DME summaries, and all supporting clinical records. Specialists coordinate with internal teams and external providers to collect missing pieces, verify physician notes, and ensure accuracy before submission by the Manager. They track timelines for expiring authorizations and communicate upcoming deadlines to ensure proactive documentation gathering. Specialists maintain detailed intake and authorization logs, monitor turnaround time, and update dashboards in real time. They also participate in internal file audits to ensure audit readiness and reduce risk of development requests. By proactively coordinating documentation, the Specialist helps maintain compliance with DOL standards and supports timely access to care. This function requires excellent organization, familiarity with EEOICPA standards, and consistent communication across roles.
3. LOMN and Development Drafting Support
The Specialist supports the creation of Letters of Medical Necessity (LOMNs) and development responses under the guidance of the Manager and Coordinator. They use pre-approved templates and clinical insight to describe disease progression, skilled care requirements, medication effects, and functional decline. Specialists are trained to incorporate DME use and skilled nursing interventions to strengthen care justification and ensure alignment with DOL expectations. When development letters are received, the Specialist assists in compiling relevant clinical records, updating or rewriting specific sections of LOMNs, and adding objective data such as PFTs or 6MWTs. Their contributions help reduce denials, shorten review cycles, and improve authorization outcomes. They also support the creation of consequential condition justifications by connecting pathophysiology and medication side effects, based on patient-specific conditions. As the DOL becomes more rigorous in review, the Specialist's role in
strengthening documentation has become increasingly critical. Their writing supports both patient advocacy and agency compliance.
4. Communication and Coordination
Specialists are responsible for tracking DME usage, requests, and fulfillment across all patients. They collaborate with the Coordinator to document which equipment patients are currently using or pending, and flag cases where additional DME may be necessary to support safety and independence. This data is integrated into LOMNs and care planning to justify hours, particularly when equipment requires two-person assist or 24/7 supervision. The Specialist also supports communication with DME vendors, confirms delivery or delays, and updates internal logs to reflect real-time equipment status. By tracking this data accurately, they ensure that all necessary information is considered in authorization documentation. This role supports higher-quality patient care and ensures alignment with DOL reimbursement practices. The Specialist plays a key role in recognizing when functional decline linked to DME use supports increased care hours. This insight contributes to stronger documentation and improved patient outcomes.
5. System Accuracy and Data Management
The Specialist works across departments to communicate status updates, collect missing documentation, and support coordination for upcoming appointments or authorizations. They participate in scheduling meetings and care conferences to provide insight into hours, DME, and clinical trends relevant to upcoming reauthorizations. The Specialist also assists in orienting new staff particularly Clinical and Business Development by answering questions, providing documentation, or redirecting staff to appropriate subject matter experts. This function includes contributing to team knowledge materials such as tip sheets, FAQs, or intake process guides. The Specialist is often the first to notice documentation gaps or referral inconsistencies and is expected to escalate concerns proactively. Their responsiveness and clarity contribute to smoother collaboration and faster resolution of intake or authorization issues. As part of a growing department, the Specialist also helps build institutional memory by supporting repeatable systems and best practices.
Education and Experience Qualifications:
- Associate’s or Bachelor’s degree in a healthcare-related field (e.g., Nursing, Health Sciences, Medical Administration, Health Information Management) or equivalent combination of education and directly related experience.
- Minimum of 3–5 years of experience in healthcare intake, authorizations, utilization management, or clinical documentation support within a regulated healthcare environment.
- Demonstrated clinical experience drafting or supporting Letters of Medical Necessity (LOMNs), including the ability to translate clinical conditions, functional limitations, disease progression, and skilled care needs into defensible written justification.
- Working knowledge of government-funded or highly regulated programs that require detailed, evidence-based justification for medical services (e.g., EEOICPA, CMS-regulated programs, Medicaid, VA, or similar).
- Proven experience assembling and coordinating authorization packets, including Plans of Care, physician documentation, clinical assessments, DME justification, and
supporting test results.
- Strong written communication skills with the ability to support defensive documentation that withstands medical review, development requests, and audits.
- High level of attention to detail and ability to manage multiple timelines, deadlines, and documentation requirements simultaneously.
- Proficiency with electronic medical records (EMRs), document management systems, spreadsheets, and workflow tracking tools.
- Preferred Qualifications:
- Clinical background as an RN, LPN, Medical Assistant, or other licensed/credentialed clinical role.
- Prior experience with Workers’ Compensation or federal authorization processes, including medical necessity review, utilization review, or appeal support.
- Direct experience responding to development letters, denials, or requests for additional justification, including revising LOMNs and compiling supplemental clinical evidence.
- Familiarity with conditions requiring complex justification (e.g., pulmonary disease, chronic pain, functional decline, mobility impairment, oxygen dependency, DME-driven care needs).
- Experience supporting programs that require objective clinical data (e.g., PFTs, 6MWTs, physician narratives, medication side-effect justification) to substantiate care hours.
- Exposure to audit-ready documentation standards and compliance-driven workflows.
- Clinical reasoning and documentation synthesis
- Regulatory awareness and risk sensitivity
- Clear, structured medical writing
- Cross-departmental coordination and follow-through
- Proactive identification of documentation gaps and escalation of risk
Additional Information:
- Competitive salary of $65,000-$75,000/year
- Eligible for discretionary bonus
- Hybrid, Full-time, Monday - Friday position
- Comprehensive medical, dental, vision, 401k, holiday pay, unlimited PTO benefits package included
- Employee Referral Program
- Employee Assistance Program
- Short-term and Long-term Disability
- Basic Life Insurance
- Six (6) paid holidays
- Opportunities for professional development and growth within the organization
- Dynamic and supportive work environment with passionate colleagues
