Authorization Specialist - Remote - Home Health

Overview

The Remote Home Health Authorization Specialist is responsible for obtaining, tracking, and maintaining prior authorizations for home health services in compliance with payer requirements. This role works closely with intake, clinical staff, physicians’ offices, and insurance providers to ensure timely approval of services, minimize delays in care, and support accurate reimbursement.

In Short

• Obtain prior authorizations and re-authorizations for home health services.
• Verify insurance eligibility and benefits for various plans.
• Submit complete authorization requests with required documentation.
• Track authorization status and follow up with payers.
• Communicate authorization approvals, denials, and limitations.
• Ensure all authorizations are accurately documented.
• Maintain compliance with payer contracts and regulations.
• Identify authorization denials and assist with appeals.
• Work closely with clinicians and physician offices.
• Fully remote, home-based role.

Requirements

• High school diploma or equivalent.
• Minimum 2+ years’ experience in home health or healthcare authorization.
• Knowledge of prior authorization processes.
• Familiarity with Medicare Advantage and Medicaid.
• Strong attention to detail.
• Proficient in EMR systems and Microsoft Office.
• Reliable high-speed internet.

Benefits

• Competitive pay and benefits.
• Flexible schedules.
• Career growth opportunities.
• Continuing education and recognition programs.
• Supportive team culture.