Prior Authorization Specialist

Patient Account Coordinator Coordinates patient accounts from prior authorization to point of bill payment or referral to collection, including processing billing for home health agencies to appropriate agencies, including Medicaid and self-pay. Maintains current knowledge of changes in billing requirements and regulations and assists in resolving billing problems. Essential Functions: Verifies patient insurance coverage and eligibility for homecare services. Processes and submits insurance claims for reimbursement. Communicates with patients, insurance companies, and healthcare providers to resolve billing issues. Maintains accurate and up-to-date patient records and billing information. Monitors and tracks outstanding claims and follows up on unpaid or denied claims. Ensures compliance with all relevant regulations and guidelines related to homecare billing and reimbursement. Education Requirement: High School Diploma or equivalent, required. Licensure Requirement: (not specified) Certifications: (not specified) Skills: (not specified) Experience: Two years of experience billing public and private insurers for medical services using computerized billing system, required. Homecare services experience, preferred. Physical Requirements: OCCASIONALLY: Flexing/extending of neck, Lifting / Carrying: 0-10 lbs, Standing, Walking FREQUENTLY: (none specified) CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing Far/near, Sitting Additional Physical Requirements performed but not listed above: Talking on the phone / in person Frequently (34 - 66%)

Created: 2026-03-04