Authorization Manager

Elite Home Health Care•New York, NY

2d•$80,000 - $85,000•Onsite

About The Position

The Authorization Manager owns the authorization function and pre-billing function end to end, including related reporting. The role manages the Authorization Coordinator team, partners directly with branch managers to review authorized visits, owns overutilization, and oversees temporary authorizations with support from the Authorization Specialist. The position protects revenue integrity by closing gaps between authorized and scheduled services. The role manages the full authorization lifecycle across payors, authorization tracking and expiration monitoring, payer follow-up, and escalations for high-risk cases. It owns the weekly pre-billing authorization review, resolves authorization-related billing discrepancies with Billing, and is accountable for preventing billing holds caused by missing or incorrect authorizations. It also oversees temporary authorizations, ensures conversion to permanent authorizations, and provides regular reporting on authorization and pre-billing performance to the Director and leadership. This is an on-site office position. The stated hiring range is $80,000–$85,000 annually.

Requirements

Supervisory or management experience in a home care, LHCSA, or managed care authorization/billing environment.
Working knowledge of HHAeXchange.
Working knowledge of ePaces.
Familiarity with MLTC, CHHA, and third-party payor authorization processes.
Strong command of revenue cycle and pre-billing mechanics.
Ability to manage a team through high-volume, time-sensitive workflows.

Responsibilities

Own the full authorization lifecycle across all payors, including new authorizations, reauthorizations, increases, decreases, extensions, and retroactive authorizations.
Manage the Authorization Coordinator team and payor portfolios, ensuring cross-coverage during absences.
Manage authorization tracking, expiration monitoring, and daily payer follow-up.
Escalate high-risk cases, including imminent expirations, high-hour patients, pediatric and fragile patients, and cases at risk of discharge.
Maintain working knowledge of payor rules, authorization duration and units, renewal timelines, and required documentation.
Own the weekly pre-billing authorization review ahead of every billing run.
Compare authorized hours with scheduled hours and resolve issues that could block claims submission, including expired authorizations, missing units, incorrect authorization types, and incorrect dates.
Resolve billing discrepancies in partnership with Billing.
Identify and resolve overutilization where delivered or scheduled hours exceed authorized units.
Process and oversee ad-hoc T-auth updates when services exceed authorization.
Report overutilization patterns by payor and branch to the Director.
Work with branch managers to review all authorized visits and serve as the authorization-side counterpart to Operations on staffing and scheduling decisions.
Flag to branches when scheduling is running ahead of authorization.
Oversee the temporary authorization process with day-to-day support from the Authorization Specialist and ensure temporary authorizations are converted to permanent authorizations.
Own reporting mechanisms for authorization and pre-billing, including volumes, turnaround times, expirations, overutilization, billing holds, and discrepancy resolution.
Deliver regular reporting to the Director and leadership.
Meet the stated KPIs: zero expired home care authorizations, zero billing holds due to missing or incorrect authorizations, overutilization identified and resolved before billing runs, and pre-billing review completed before every billing cycle.