Eligibility & Authorization Coordinator

AgeRight•Milwaukie, OR

1d•Onsite

About The Position

Coordinates insurance verification, payer eligibility review, prior authorizations, and documentation requirements to ensure timely admission and continuation of home health services.

Requirements

High school diploma required
Knowledge of Medicare, Medicaid, managed care, EMR systems, payer regulations
Communication skills
Organization skills
Problem-solving skills

Nice To Haves

associate or bachelor degree preferred
Experience in home health intake, insurance verification, authorizations, or healthcare administration preferred
Be open to cross-training on the other positions under the intake department

Responsibilities

Verify insurance eligibility and benefits prior to admission.
Obtain and track prior authorizations and recertifications.
Review referrals for payer requirements and coverage criteria.
Coordinate with referral sources, clinicians, and payers.
Maintain authorization logs and expiration dates.
Resolve authorization denials and request additional documentation.
Support timely intake processing and patient admission.
Ensure compliance with CMS, Medicare, Medicaid, and commercial payer requirements.
Maintain accurate records in EMR systems.
Generate reports related to authorization status and payer trends.