Intake and Authorization Specialists

University of Virginia•Charlottesville, VA

12d•Remote

About The Position

Authorization and Intake Specialist play a critical role in facilitating timely access to home health services by coordinating patient referrals, verifying insurance coverage, and securing prior authorizations. This position serves as a central point of communication between referral sources, clinicians, patients, and payers to ensure a smooth transition from hospital or provider settings into home-based care. Key responsibilities include reviewing incoming referrals for completeness and eligibility, obtaining and documenting insurance authorizations, and ensuring compliance with payer requirements and regulatory standards. The specialist collaborates closely with clinical and administrative teams to prioritize referrals, address barriers to care, and support efficient patient onboarding. This role requires strong organizational skills, attention to detail, and knowledge of insurance processes, including Medicare, Medicaid, and commercial payers. Effective communication, critical thinking, and the ability to manage high-volume workflows are essential to support continuity of care and optimize patient outcomes in the home health setting.

Requirements

Bachelor's Degree or combination of education and related experience in lieu of a degree required.
3+ years of relevant experience required.
Strong organizational skills.
Attention to detail.
Knowledge of insurance processes, including Medicare, Medicaid, and commercial payers.
Effective communication skills.
Critical thinking skills.
Ability to manage high-volume workflows.

Responsibilities

Receiving, reviewing, and processing incoming referrals from hospitals, providers, and community sources to facilitate timely home health services.
Verifying patient eligibility and insurance benefits across Medicare, Medicaid, and commercial payers.
Obtaining and documenting prior authorizations in accordance with payer requirements.
Ensuring all required documentation such as physician orders, face-to-face encounters, and clinical records is complete and compliant with regulatory standards.
Accurately entering and maintaining patient information within the electronic medical record system.
Prioritizing referrals based on urgency, payer guidelines, and patient needs.
Monitoring authorization status and proactively following up with payers to prevent delays in care.
Strict adherence to agency policies, state and federal regulations, and accreditation standards.
Supporting performance improvement initiatives aimed at enhancing intake efficiency, patient satisfaction, and reimbursement outcomes.