Authorizations Coordinator

Pinnacle Home Care • Oldsmar, FL

4d • Onsite

About The Position

Pinnacle Home Care, Florida’s largest independent Medicare-certified home health provider, is seeking Authorizations Coordinators to join their award-winning team. This role is crucial in delivering compassionate, high-quality, patient-centered care by coordinating and processing patient authorizations. The Authorizations Coordinator will work directly with various internal and external stakeholders, including branches, clinicians, Case Managers, Physicians, insurance representatives, and outside vendors, to ensure timely and accurate authorization for patient services. This position requires a detail-oriented individual with strong organizational skills, excellent communication abilities, and a commitment to patient well-being.

Requirements

• Knowledge of medical terminology, CPT, HCPCS, and ICD coding.
• Strong organizational and time management skills with the ability to effectively prioritize and complete tasks.
• Ability to constructively work independently when faced with high workloads and deadlines.
• Excellent written and verbal communication skills with the ability to address customer concerns in a courteous and timely manner.
• Strong knowledge of relevant computer systems.
• Must be detail-oriented with the ability to multi-task and be open to cross-functional training in all departments.
• Serve in a highly patient-focused role that works directly with our branches, clinicians, Case Managers, Physicians/ PCP(s), insurance representatives, outside vendors, and other medical personnel.

Responsibilities

• Coordinate and process patient authorization to completion with precision, detail, and accuracy.
• Obtain and track all authorization and re-authorization as indicated by payer(s), or by scheduled visits by the clinician for services ordered/requested in a timely manner.
• Review and resolve KanTime authorization issues.
• Communicate with branches, eligibility, and Intake when patient insurance has changed.
• Transmit documents provided by the agency OASIS, POC, and orders provided by the referring facility or provider to support the authorization request throughout the life cycle of the patient treatment/episode.
• Coordinate and communicate with the appropriate agency personnel and/or billing department regarding any changes or updates from the payer in a timely manner.
• Provide front-line support to agency for authorization dates in comparison to patient treatment (SOC) dates and scheduling issues that arise from authorization need.
• Communicate professionally with inter-company departments on resolution of potential disputed items.
• Effectively manage the authorization throughout the course of a patient episode to ensure that the patient’s treatment coincides with the authorization provided by the Insurance carrier.
• Assign any Office Authorization as needed for patient care to continue without delay, until authorization has been submitted and returned with a decision.
• Monitor Zendesk, KanTime fax inquiries, and incoming faxes throughout the day to update patient authorization status and adhere to any failed faxes in KanTime requiring more information to process authorization.
• Analyze and reconcile complex issues and problems.
• Prepare and analyze appropriate reports and other business correspondence.
• Identify needs and opportunities and present them to the supervisor with recommended solutions.
• Meet productivity goals assigned by the Authorization Supervisor.
• Adhere to federal, state, and agency regulations and policies to maintain confidentiality of patients and agency information per HIPPA requirements.
• Respond to all inquiries with a resolution to concerns and/or discrepancies.

Benefits

• Personalized, One-on-One Care
• Growth & Stability
• Ongoing Professional Development: Free Continuing Education Units (CEUs) to support licensure and career advancement.
• Competitive Benefits & Perks: Including an employee referral program where you can earn rewards.
• Recognized Excellence: Ranked as a USA Today Top Workplace.
• Flexible Scheduling
• Supportive & Fun Culture

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed