Authorizations Coord.

Are you looking to make a difference in patients lives with a company that values your expertise Join us in our mission of delivering compassionate healthcare where it matters most at home.

Pinnacle Home Care Floridas largest independent Medicare-certified home health provider has been delivering high-quality patient-centered care for over two decades and were looking for Authorizations Coordinators to join our award-winning team.

Key Responsibilities

• Coordinate and process patient authorization to completion with precision detail and accuracy.
• Must be detail-oriented with the ability to multi-task and be open to cross-functional training in all departments.
• Serve in a highly patient-focused role that works directly with our branches clinicians Case Managers Physicians/ PCP(s) insurance representatives outside vendors and other medical personnel.
• Obtain and track all authorization and re-authorization as indicated by payer(s) or by scheduled visits by the clinician for services ordered/requested in a timely manner.
• Review and resolve KanTime authorization issues.
• Communicate with branches eligibility and Intake when patient insurance has changed.
• Transmit documents provided by the agency OASIS POC and orders provided by the referring facility or provider to support the authorization request throughout the life cycle of the patient treatment/episode.
• Coordinate and communicate with the appropriate agency personnel and/or billing department regarding any changes or updates from the payer in a timely manner.
• Provide front-line support to agency for authorization dates in comparison to patient treatment (SOC) dates and scheduling issues that arise from authorization need.
• Communicate professionally with inter-company departments on resolution of potential disputed items.
• Effectively manage the authorization throughout the course of a patient episode to ensure that the patients treatment coincides with the authorization provided by the Insurance carrier.
• Assign any Office Authorization as needed for patient care to continue without delay until authorization has been submitted and returned with a decision.
• Monitor Zendesk KanTime fax inquiries and incoming faxes throughout the day to update patient authorization status and adhere to any failed faxes in KanTime requiring more information to process authorization.
• Analyze and reconcile complex issues and problems.
• Prepare and analyze appropriate reports and other business correspondence.
• Identify needs and opportunities and present them to the supervisor with recommended solutions.
• Meet productivity goals assigned by the Authorization Supervisor.
• Adhere to federal state and agency regulations and policies to maintain confidentiality of patients and agency information per HIPPA requirements.
• Respond to all inquiries with a resolution to concerns and/or discrepancies.

Qualifications

• Knowledge of medical terminology CPT HCPCS and ICD coding.
• Strong organizational and time management skills with the ability to effectively prioritize and complete tasks.
• Ability to constructively work independently when faced with high workloads and deadlines.
• Excellent written and verbal communication skills with the ability to address customer concerns in a courteous and timely manner.
• Strong knowledge of relevant computer systems.

Why Choose Pinnacle

• Growth & Stability: Over two decades as Floridas largest independent home health agency.
• Competitive Benefits & Perks: Including an employee referral program where you can earn rewards.
• Recognized Excellence: Ranked as a USA Today Top Workplace.
• Supportive & Fun Culture: Join a collaborative forward-thinking team that values both professional excellence and personal fulfillment.

Pinnacle promotes an inclusive environment and is an equal opportunity employer. We prohibit discrimination or harassment based on race religion age gender national origin disability veteran status or other legally protected characteristics.

Be part of a company that empowers clinicians to make a difference in the lives of over 10000 patients across Florida every day. Apply now!