Home Health Authorization Coordinator - #1399002

Warm Hearth Village

A Nonprofit Community

Our Mission: Fostering a person-centered approach to aging in an inclusive environment that redefines retirement.

Our Vision: To nurture a transformative culture where people live and work in community, knowing their contributions are essential to our success.

Our Values: Innovation, Community Collaboration, Passion, Inclusiveness and Ethics.

Position Summary

We are seeking a detail-oriented and organized Home Health Authorization Coordinator to join our team. This role is responsible for obtaining, tracking, and managing all prior authorizations for home health services. The ideal candidate will have a solid understanding of insurance requirements and home health regulations and will work closely with clinical and administrative staff to ensure timely, accurate authorization processing.

Key Responsibilities

• Submit and track prior authorization requests for all home health services, including nursing, therapy, and aide care
• Verify insurance eligibility, benefits, and authorization requirements
• Communicate with insurance companies, physicians, and internal departments to gather required documentation and respond to requests
• Monitor pending authorizations and follow up on delayed or denied requests
• Maintain accurate and up-to-date records in EMR and tracking systems
• Notify clinical teams of authorization statuses to ensure compliant service delivery
• Assist with appeals or peer-to-peer processes when authorizations are denied
• Ensure compliance with all applicable payer guidelines, HIPAA, and company policies
  
  

Qualifications

• High school diploma or equivalent required; associate degree or relevant certification preferred
• Minimum 2 years of experience in home health, healthcare billing, or insurance authorization
• Strong understanding of Medicare, Medicaid, and commercial insurance plans
• Familiarity with EMR systems and medical terminology
• Excellent communication, organizational, and time management skills
• Ability to work independently in a fast-paced environment and meet tight deadlines
• High attention to detail and accuracy
  
  

Preferred Qualifications

• Experience with MatrixCare
• Knowledge of home health-specific documentation requirements
  
  

Hiring Manager: Josh Toney-Administrator- [email protected]