HPSC-Home Health Intake & Authorization Coordinator

Frontpoint Health•Longview, TX

4d•Onsite

About The Position

The Home Health Intake & Authorization Coordinator is responsible for managing the referral intake process, obtaining insurance authorizations, verifying patient eligibility, and coordinating the start of care. This position serves as a liaison between referral sources, physicians, insurance companies, clinical staff, and patients to ensure timely, accurate, and compliant admissions.

Requirements

High school diploma or GED required.
Knowledge of Medicare, Medicare Advantage, other payers, and prior authorization requirements.
Strong understanding of home health eligibility requirements and physician documentation.
Excellent organizational, multitasking, and problem-solving skills.
Strong verbal and written communication skills.
Proficiency in Microsoft Office and computer applications.
Ability to work independently and as part of a multi-disciplinary team.
Excellent attention to detail.
Ability to prioritize multiple referrals in a fast-paced environment.
Strong customer service skills when interacting with patients, families, referral sources, and physicians.
Ability to maintain confidentiality and professionalism.
Knowledge of medical terminology and insurance billing processes.
Prolonged periods of sitting and computer work.
Ability to communicate effectively by telephone and in person.
Ability to occasionally lift up to 20 pounds.

Nice To Haves

Minimum of 2 years of home health intake, insurance authorization, or medical office experience preferred.
Experience with Homecare Homebase.

Responsibilities

Receive, review, and process incoming home health referrals.
Verify insurance eligibility and benefits for all new referrals.
Obtain prior authorizations and continued service authorizations from Medicare Advantage plans, and other payers.
Coordinate with physicians to obtain face-to-face documentation, and any additional required paperwork.
Ensure referrals meet Medicare and payer-specific coverage criteria.
Enter patient demographics, insurance information, physician orders, and referral documentation into the electronic medical record (EMR).
Maintain communication with referral sources regarding referral status.
Track authorization expiration dates and request extensions or additional visits as needed.
Resolve insurance authorization issues that may delay patient admission or continuation of services.
Maintain accurate documentation and comply with HIPPA, Medical Conditions of Participation, and agency policies.
Assist with census growth by facilitating timely admissions.
Participate in quality improvement initiatives and workflow optimization.
Perform other duties as assigned.