Job Description
Position Summary
The Home Health (HH) and Hospice (HOS) Authorization & Eligibility Specialist is responsible for verifying insurance coverage, determining patient eligibility, and securing timely authorizations for home health and hospice services. This role ensures accurate and compliant processing to support patient access to care while reducing reimbursement risk. The specialist works closely with clinical staff, referral sources, payers, and internal billing teams to provide exceptional service and efficient coordination.
Key Responsibilities
Authorization & Eligibility
Verify insurance eligibility and benefits for all incoming home health and hospice referrals.
Obtain prior authorizations from commercial, Medicare Advantage, Medicaid, and other payers as required.
Review clinical documentation to ensure authorization requests meet payer requirements.
Track authorization status, submit...
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