Prior Authorizations Specialist

Pennant Group•Tacoma, NC

2d•$25 - $30•Remote

About The Position

Puget Sound Home Health & Hospice is seeking an experienced Insurance Prior Authorization Specialist to help ensure patients receive the care they need without unnecessary delays. The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at http://www.pennantgroup.com.

Requirements

2 years of Home Health and/or Hospice agency prior authorization or billing experience
Homecare Homebase (HCHB) experience required
Strong attention to detail and ability to manage multiple priorities
Excellent written and verbal communication skills
Strong customer service and collaborative problem-solving skills
Ability to stay organized and work independently in a remote environment

Responsibilities

Verify primary and secondary insurance coverage and patient eligibility
Obtain visit authorizations from payers and submit required clinical documentation
Verify Medicare and Medicaid eligibility using UGS/DDE and EDS
Enter and maintain accurate authorization and patient information in Homecare Homebase (HCHB)
Track authorized and unauthorized visits and follow up as needed
Maintain current payer requirements and initiate appeals for denied authorizations
Prepare patient copay estimates and communicate authorized visits to scheduling
Collaborate with clinical, contracting, scheduling, and office teams to resolve authorization issues
Assist patients, referral sources, and community partners with payer authorization and coverage questions