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Pinnacle Home Care, Florida’s largest independent Medicare-certified home health provider, has been delivering high-quality, patient-centered care for over two decades, and we’re looking for Authorizations Coordinators to join our award-winning team.
Key Responsibilities
- Coordinate and process patient authorization to completion with precision, detail, and accuracy.
- Must be detail-oriented with the ability to multi-task and be open to cross-functional training in all departments.
- Serve in a highly patient-focused role that works directly with our branches, clinicians, Case Managers, Physicians/ PCP(s), insurance representatives, outside vendors, and other medical personnel.
- Obtain and track all authorization and re-authorization as indicated by payer(s), or by scheduled visits by the clinician for services ordered/requested in a timely manner.
- Review and resolve KanTime authorization issues.
- Communicate with branches, eligibility, and Intake when patient insurance has changed.
- Transmit documents provided by the agency OASIS, POC, and orders provided by the referring facility or provider to support the authorization request throughout the life cycle of the patient treatment/episode.
- Coordinate and communicate with the appropriate agency personnel and/or billing department regarding any changes or updates from the payer in a timely manner.
- Provide front-line support to agency for authorization dates in comparison to patient treatment (SOC) dates and scheduling issues that arise from authorization need.
- Communicate professionally with inter-company departments on resolution of potential disputed items.
- Effectively manage the authorization throughout the course of a patient episode to ensure that the patient’s treatment coincides with the authorization provided by the Insurance carrier.
- Assign any Office Authorization as needed for patient care to continue without delay, until authorization has been submitted and returned with a decision.
- Monitor Zendesk, KanTime fax inquiries, and incoming faxes throughout the day to update patient authorization status and adhere to any failed faxes in KanTime requiring more information to process authorization.
- Analyze and reconcile complex issues and problems.
- Prepare and analyze appropriate reports and other business correspondence.
- Identify needs and opportunities and present them to the supervisor with recommended solutions.
- Meet productivity goals assigned by the Authorization Supervisor.
- Adhere to federal, state, and agency regulations and policies to maintain confidentiality of patients and agency information per HIPPA requirements.
- Respond to all inquiries with a resolution to concerns and/or discrepancies.
Qualifications
- Knowledge of medical terminology, CPT, HCPCS, and ICD coding.
- Strong organizational and time management skills with the ability to effectively prioritize and complete tasks.
- Ability to constructively work independently when faced with high workloads and deadlines.
- Excellent written and verbal communication skills with the ability to address customer concerns in a courteous and timely manner.
- Strong knowledge of relevant computer systems.
Why Choose Pinnacle?
- Personalized, One-on-One Care: Help patients heal and regain their independence by delivering individualized care in the comfort of their homes.
- Growth & Stability: Over two decades as Florida’s largest independent home health agency.
- Ongoing Professional Development: Free Continuing Education Units (CEUs) to support licensure and career advancement.
- Competitive Benefits & Perks: Including an employee referral program where you can earn rewards.
- Recognized Excellence: Ranked as a USA Today Top Workplace.
- Flexible Scheduling: Enjoy a schedule that aligns with your personal priorities.
- Supportive & Fun Culture: Join a collaborative, forward-thinking team that values both professional excellence and personal fulfillment.
Be part of a company that empowers clinicians to make a difference in the lives of over 10,000 patients across Florida every day. Apply now!
