Insurance Specialist - Home Care

Care Advantage Corporate•Richmond, VA

10d•Hybrid

About The Position

Join a Team That Truly Cares At Care Advantage, we believe exceptional care starts with exceptional people. For nearly 40 years, we've helped seniors and families remain safe, comfortable, and independent at home through compassionate, high-quality care. As we continue to grow, we're seeking an experienced and detail-oriented Insurance Specialist to join our Medicaid and Insurance Services team. If you thrive in a fast-paced environment, enjoy solving problems, building relationships, and ensuring critical authorizations are secured so clients can receive the care they need, this could be the perfect opportunity for you. At Care Advantage, our culture is guided by our new iCARE Values : Integrity – We do the right thing, even when no one is watching. Compassion – We treat everyone with empathy, dignity, and kindness. Accountability – We own our actions and deliver on our commitments. Respect – We value every individual and every experience. Excellence – We continuously improve and strive to be our best every day.

Requirements

High School Diploma or GED
Strong administrative and organizational skills
Excellent verbal and written communication abilities
Proficiency with Microsoft Office applications
Ability to analyze information and maintain accurate records

Nice To Haves

Associate degree
Home care, healthcare, insurance, Medicaid, or managed care experience
Knowledge of Medicaid regulations and authorization processes
Experience with long-term care insurance verification and authorization
Familiarity with payer portals and healthcare documentation systems

Responsibilities

Manage Medicaid and Long-Term Care Insurance authorizations from start of care through discharge.
Submit, extend, renew, and update authorizations as client needs change.
Verify insurance coverage and eligibility prior to service initiation.
Navigate insurance, Medicaid, MCO, and Atrezzo portals to obtain and maintain approvals.
Communicate with families, social service agencies, healthcare plans, and internal teams regarding eligibility and authorization requirements.
Monitor authorization status and proactively resolve payer-related issues.
Maintain accurate client records and documentation.
Build positive relationships with managed care organizations and payer partners.
Support billing and compliance requirements through timely and accurate documentation.
Collaborate with branch and clinical teams to ensure seamless service delivery.
Assist with special projects and other duties as assigned.