Insurance Authorization Specialist
Job Posting for Insurance Authorization Specialist at Family Home Health / Three Rivers Hospice
About Quality Life Services
We are a family owned and operated healthcare network in Western PA. We have over 40 years of industry-leading experience and offer a wide range of services from skilled nursing, personal care, home health, hospice, as well as our own pharmacy. We see our employees as a part of our family.
Why Quality Life Services?
- Welcoming and supportive atmosphere
- Significant employer contributions to health insurance premiums from Highmark Health
- Robust voluntary benefits package including 401K, life insurance, accident insurance, and more
- Generous earned Time Off (ETO) and an ETO buy-back twice a year
- Educational benefits such as tuition reimbursement and student loan repayment
- Employee Assistance Programs and Chaplain Services
- Professional development and growth opportunities
Responsibilities
- Facilitate a timely comprehensive exchange of pertinent information with insurance carriers/payers
- Obtain preauthorization for initial and ongoing home nursing services
- Provide a customized review of the patient’s health status to meet the expectations of the payer
- Develop a rapport and approach with the payer to facilitate the coordination of patient care
- Document verification of eligibility or preauthorization on the appropriate forms and submit documentation
- Carry out the role of patient advocate, representing the condition of the patient to payers and advocate for services needed
- Establish pre-admission health care eligibility requirements
- Obtain and document prior authorization for home care services from insurance providers
Requirements
- High school diploma or GED
- 3 years’ experience in health care managed care coordination, preferably in home health care
- Excellent communication skills
At Quality Life Services, we don’t just accept difference — we celebrate it, we support it, and we thrive on it for the benefit of our employees, our residents, and our communities. We are proud to be an equal opportunity workplace and an affirmative action employer.
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Job openings at Family Home Health / Three Rivers Hospice
Castle, PA
Full Time
Monroeville, PA
Full Time
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