Position Summary:
The Authorization Monitoring and Tracking Specialist is responsible for managing and overseeing all payer authorization processes to ensure timely approval and continuity of patient care. This position plays a vital role in coordinating with care coordinators, payers, and clinical teams to track, follow up, and record all initial and additional authorizations accurately and efficiently.
Key Responsibilities:
- Review new referrals & additional visit requests daily, log into the Authorization Tracker.
- Monitor payer portals (e.g., Kaiser, Carelon, other insurance); follow up if no response in 48 hours.
- Notify care coordinators on approvals/denials with authorization, dates, visit counts, and conditions.
- Enter approvals into the back-office/EMR; attach letters/screenshots; ensure billing/scheduling visibility.
- Flag expiring authorizations (7–10 days out); compile weekly summary for DPCS.
- Escalate after 5 business days without response or for repeated denials/urgent cases.
- Maintain organized, audit-ready records (letters, emails, date-stamped trackers).
Qualifications:
- Experience in Home Health or Hospice setting (required).
- Strong knowledge of payer portals (Kaiser, Carelon, and other insurance).
- Excellent attention to detail and organizational skills.
- Proficiency with Excel, EMR/Back Office systems, and email communication.
- Strong communication skills (verbal and written).
- Ability to manage multiple authorizations and deadlines in a fast-paced environment.
Preferred:
- Prior experience as an Authorization Coordinator, Intake Coordinator, or Care Coordination Assistant in home health or healthcare setting.
- Familiarity with CMS and payer authorization guidelines.
Benefits:
- Competitive pay.
- Health, dental, and vision insurance.
- Paid time off (PTO), paid sick days and holidays.
- Opportunities for growth within the agency.
- Supportive and team-oriented work environment.
To Apply
Send your resume and cover letter to this posting with the subject line:
“Authorization Monitoring and Tracking Specialist – [Your Name]”