Insurance Authorization Coordinator (In-Office)

Job Description Summary

We’re looking for a Insurance Authorization Coordinator to join our team at Southwest Florida Home Care! In this role, you’ll play an essential part in making sure patients’ insurance details are verified and benefit authorizations are processed. You’ll work closely with both our clinical and financial teams, helping everything run smoothly, staying compliant with regulations, and ensuring we’re reimbursed properly. Your contributions will directly impact the success of our patient care and the overall efficiency of our operations.

Essential Job Functions/Responsibilities

Insurance Verification & Authorizations

• Verifies insurance coverage, eligibility, and home health benefits for all patients.
• Confirms in/out-of-network status and authorization requirements.
• Obtains and tracks prior authorizations, ensuring timely submission and renewals.
• Checks MECCA eligibility for admissions and resumptions of care; reports variances.
• Collects complete and accurate insurance and demographic information at intake.
• Coordinates with physicians responsible for plan-of-care certification.

Compliance & Regulatory Support

• Supports compliance efforts related to reimbursement, documentation, and billing processes.
• Participates in quality improvement initiatives and continuous process evaluation.
• Maintains strict confidentiality and complies with HIPAA regulations.

Interdepartmental Collaboration

• Works closely with Clinical Intake, Nursing, and Financial departments to align patient care and billing processes.
• Assists the Clinical Intake Coordinator to ensure timely start of care.
• Serves as a resource to staff regarding insurance and authorizations.

Customer Service & Professional Conduct

• Establishes and maintains positive relationships with patients, families, payers, and referral sources.
• Demonstrates ethical behavior, integrity, and commitment to the organization's mission and values.
• Attends staff meetings, in-services, and agency performance improvement activities as requested.
• Communicates effectively both verbally and in writing and maintains professionalism in all interactions.
• Promotes a safe, respectful, and collaborative working environment.

Position Qualifications

1. High school diploma, Associate’s degree, or equivalent experience required.

2. Minimum 3 years of experience in healthcare, insurance verification, and authorizations (home health preferred).

3. Minimum 1 year of Home Health experience.

4. Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines.

5. Proficient in billing systems, EHR platforms, and Microsoft Office Suite.

6. Excellent communication, organizational, and problem-solving skills.

7. Detail-oriented with the ability to manage multiple tasks in a fast-paced environment.

8. Demonstrates professionalism, confidentiality, and a patient-centered approach.

9. Reliable attendance and ability to work both independently and as part of a team.

10. Wellsky-Kinnser EMR system knowledge experience.

Job Type: Full-time

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: In person