Home Health and Hospice Prior Authorizations Specalist

Join Our Team as an Insurance Prior Authorization Specialist at Alpha Home Health & Hospice. On-site in our office located in Mount Vernon, WA or remote in PST or MST time zones only.

Benefits:

• $23-28 per hour, DOE
• Comprehensive Medical, Dental, and Vision insurance
• Free health concierge services
• FSA and HSA accounts
• Paid Life and AD&D insurance
• Paid Sick, Holidays, and PTO
• STD, LTD, and other voluntary insurance plans
• Company-wide celebrations of your great work & accomplishments
• Support for your professional growth and development
• Room for advancement
• AMAZING teammates & leaders who are supportive, inclusive, and fun!

What Do We Require of a Prior Authorization Specialist?

• MUST have at least 1 year of insurance authorization/billing experience in home health/hospice.
• Experience with Home Care Home Base is required
• Prefer onsite but will consider remote if candidate lives in PST or MST time zones
• Demonstrated cooperation and excellent customer service skills
• Ability to multi-task and stay on task in a fast-paced office
• Excellent team-oriented, verbal, and written communication skills

Key Responsibilities:

• Verify insurance coverage, including primary and secondary payors
• Use UGS/DDE and EDS programs to verify Medicare/Medicaid eligibility
• Obtain visit authorization via payor by providing appropriate medical records
• Perform accurate data entry in patient records within HCHB
• Maintain payor files with up-to-date requirements to obtain/initiate appeals for denied authorizations
• Interface with contract, clinical, and office staff to foster collaboration and positive working relationships
• Prepare patient co-pay estimates and notify scheduling of authorized visits
• Provide excellent customer service to patients, referral sources, and community contacts with questions regarding payor prior authorizations and medical guidelines
• Enter, audit, and follow up on authorized and unauthorized visits within HCHB

Why Alpha Home Health & Hospice?

At Alpha Home Health & Hospice, we pride ourselves on our quality of care and ethical business practices, guided by our foundational Core Values of CAPLICO:

• Customer Second (Employee First!)
• Accountability
• Passion for Learning
• Love One Another
• Intelligent Risk Taking
• Celebration
• Ownership