Job Description

Job Title:

Authorization & Eligibility Specialist - Home Health & Hospice

Department:

Billing Services - RCM

Reports To:

Supervisor, Billing Services

Location:

Chennai, IN

Job Type:

Full-Time

Position Summary:

The Authorization & Eligibility Specialist plays a critical role in supporting the operational success of our Home Health and Hospice agencies. This position is responsible for verifying patient insurance eligibility, obtaining prior authorizations, and ensuring timely and accurate documentation to support patient access to care and reimbursement. As we continue to grow our Home Health and Hospice services, this role is essential to maintaining service excellence and operational efficiency.

Key Responsibilities:

Verify patient insurance eligibility and benefits for Home Health and Hospice services using payer portals, phone calls, and internal systems. Obtain and track prior authorizations from insurance providers in a timely manner to avoid delays in patient care. Accurately document all authorization and eligibility information in the appropriate systems. Collaborate with clinical, intake, and billing teams to ensure alignment and timely communication of authorization statuses. Monitor authorization expirations and proactively initiate renewals as needed. Resolve authorization and eligibility-related issues by working directly with payers and internal stakeholders. Maintain up-to-date knowledge of payer requirements, authorization processes, and regulatory guidelines. Participate in process improvement initiatives to enhance workflow efficiency and accuracy. Support onboarding and training of new team members as needed.

Qualifications:

High school diploma or equivalent required; Associate's or Bachelor's degree preferred. Minimum of 2 years of experience in healthcare authorization, insurance verification, or medical billing, preferably in a Home Health or Hospice setting. Strong understanding of insurance plans, payer requirements, and medical terminology. Proficiency in using electronic health records (EHR) and payer portals. Excellent communication and interpersonal skills. Strong attention to detail and organizational skills. Ability to work independently and collaboratively in a fast-paced environment.

Preferred Qualifications:

Experience with Medicare, Medicaid, and commercial insurance payers. Familiarity with Home Health and Hospice billing and authorization processes. Bilingual skills are a plus.

Joining us is more than saying "yes" to making the world a healthier place. It's discovering a career that's challenging, supportive and inspiring. Where a culture driven by excellence helps you not only meet your goals, but also create new ones. We focus on creating a diverse and inclusive culture, encouraging individual expression in the workplace and thrive on the innovative ideas this generates. If this sounds like the workplace for you, apply now! We commit to respond to every applicant.