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Home Health Authorization Specialist

Trinity Health At Home

As a Home Health Authorization Specialist you will be responsible and accountable for the processing of all THAH authorization documentation meeting HCFA/MCC/JCAHO regulations and guidelines. Primary responsibilities include processing all front1end documentation needed to meet third party payer authorization deadlines assuring accurate addition monitors all accounts for ongoing authorization needs to ensure optimal reimbursement and compliance with agency policy. This position works closely with the THAH insurance team and THAH Collection analysts in the tracking of authorizations and resolution of problematic billing issues. Monitors pending authorizations report and collaborate with both the clinical and revenue cycle team to review and resolve pending claims to ensure timely payment. Duties may be accomplished in a remote work environment.

Why Youll Love Working With Us

Start Here Grow Here Stay Here!

We dont just offer jobswe build long-term careers. Many of our nurses have grown into leadership roles because we invest deeply in your development well-being and success.

Heres what you can look forward to:

Consistent Predictable Schedules

Enjoy reliable workloads with guaranteed hoursno guessing no stress.

Competitive Pay & Affordable Benefits

Access comprehensive low-cost benefits and compensation that truly reflects your expertise.

Supportive Visible Leadership

Youll always feel backed by leaders who understand home care and are committed to helping you excel.

Clear Pathways for Career Growth

Every leader on our team began in a field roleyou can grow here too.

Epic EMR System

Experience streamlined charting and communication with one of the most trusted systems in healthcare.

Fast Candidate-Friendly Hiring Process

Quick interviews and prompt offerswe respect your time.

Deeply Meaningful Work

Deliver one-on-one relationship-driven care that makes a real difference in the lives of patients and families.

Essential Functions

• Prepares and enters data into the appropriate software assuring the accuracy of the regulated client account following all regulations placed on the homecare agency. Ensures that input of information is accurate and authorization is received timely for the submission of claims. Responds to all system issues by preparing documentation for the resolution center. Timely follow up on pending authorizations to ensure payment of claims.

• Generates all authorization documentation needed to be billed in a timely manner assuring industry standards are met. Monitors and processes the Subsequent Authorizations workflow and reports daily to assure timely and clean billing.

• Utilizing the CQI Process Improvement technique responsible for implementing and monitoring changes to processes to ensure continued integrity of client accounts. Collaborates with the Intake Department to identify processes for improvement ensuring the accuracy of the authorization process.

• Provides statistical feedback regarding the status of unbilled claims due to authorizations to THAH Revenue team on a weekly basis or as defined by policy.

• Interfaces with THAH to resolve problems related to the processing of bills/claims. Investigate client accounts and provides any additional documentation required.

• Seeks assistance of Clinical Team Leaders and/or Revenue Cycle Leaders with clinical data entry and/or billing problems.

• Coordinates the flow of billing related paperwork between the branch and THAH Service Center. Works with the branch and THAH colleagues to identify areas of improvement related to authorization workflow. Actively participates in all billing conference calls between the agency and THAH

Minimum Qualifications

• The incumbent is able to articulate and demonstrate a commitment to the mission vision and values of

• Trinity Health and to inspire active support of these in others.

• The preferred candidate will have a high school diploma or GED.

• College business courses or an Associates Degree is preferred or four to six years of experience in a

• medical billing office setting with a concentration on authorizations.

• A strong knowledge of general business office functions strong analytical and organizational skills and

• microcomputer usage is required.

• Incumbent must possess the following: ability to meet strict deadlines with high level of accuracy ability to

• prioritize multiple tasks in highly automated setting and possess strong interpersonal skills.

• Ability to consistently demonstrate commitment to the mission and Organizational Code of Ethics and

• adhere to the Compliance

What We Offer

• Medical dental and vision coverage starting Day One

• Short- and long-term disability

• 403(b) retirement plan with employer match

• Generous paid time off plus 7 paid holidays

• Tuition reimbursement up to $5250/year

• Comprehensive onboarding and orientation program

About Trinity HealthAtHome

Trinity Health At Homeis anational home care hospice and palliative care organization serving communities throughout eleven states. As a faith-based not-for-profit agency we serve patients and families in the comfort of home offering skilled nursing therapy (physical occupational speech)and medical social are Medicare-certified and accredited by The Joint Commission. Learn more about us at Commitment

Rooted in our Mission and Core Values we honor the dignity of every person and recognize the unique perspectives experiences and talents each colleague brings. By finding common ground and embracing our differences we grow stronger together and deliver more compassionate person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability veteran status or any other status protected by federal state or local law.