Weekend Managed Care Coordinator

🔥 56 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $18 - $20 / hour

⏱ Part Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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Concierge Home Care

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2015

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

Concierge Home Care is a Florida-based home healthcare agency that provides personalized in-home care services for seniors, helping them manage chronic conditions and remain safely in their homes. The company operates in hundreds of cities across Florida, employs carefully screened and insured caregivers, uses multidisciplinary care plans, coordinates with discharge planners and healthcare professionals, and assists with Medicare and insurance coverage. It also offers career opportunities, a franchise/network option for other home health agency owners, and emphasizes HIPAA-compliant practices and community-focused care.

📋 Description

• Complete daily insurance eligibility and benefit verification for new and existing patients • Review patient insurance information and identify payer requirements • Verify coverage, benefits, limitations, and authorization requirements • Monitor and reconcile insurance changes • Maintain accurate payer and patient information within the EMR • Obtain initial authorizations for home health services • Monitor authorization status and expiration dates • Obtain reauthorizations to support continued patient care • Follow up with insurance companies and managed care organizations regarding pending authorizations • Document authorization information accurately within the EMR • Maintain processes to prevent authorization gaps • Navigate payer portals and electronic authorization systems • Submit required documentation supporting authorization requests • Follow up on outstanding requests and resolve authorization-related issues • Maintain professional relationships with payer representatives • Maintain complete records of eligibility, benefits, authorizations, and reauthorizations • Protect confidential patient and insurance information in accordance with HIPAA regulations • Follow company policies and established managed care processes • Collaborate with Intake to support timely referral processing • Partner with Operations regarding authorization requirements and patient status • Communicate with Sales and referral sources when payer information or authorization requirements affect patient acceptance • Escalate authorization concerns or potential coverage issues appropriately

🎯 Requirements

• Some college • Minimum 2 years of recent experience obtaining medical insurance authorizations • Experience with insurance eligibility and benefit verification • Experience communicating with insurance companies and managed care organizations • Experience navigating insurance portals and authorization systems • Experience working with an EMR or electronic healthcare documentation system • Strong attention to detail and accuracy • Excellent organizational and follow-through skills • Ability to manage multiple authorization requests and deadlines simultaneously • Strong written and verbal communication skills • Ability to work collaboratively with multiple departments • Ability to maintain patient confidentiality and follow HIPAA requirements • Preferred: experience in home health, hospice, healthcare, or another post-acute setting • Preferred: knowledge of home health insurance authorization and reauthorization processes • Preferred: familiarity with medical terminology • Preferred: experience working with multiple EMR platforms • Preferred: experience with Medicare Advantage, managed care, Medicaid, commercial insurance, or other healthcare payors • Preferred: experience working in a high-volume Intake or Managed Care environment • Successful completion of an AHCA Level 2 background screening may be required

🏖️ Benefits

• Structured onboarding and training • Opportunities for professional growth within Intake and Operations • Supportive leadership and collaborative team environment • Meaningful work helping patients access home health services • Exposure to multiple insurance plans and managed care processes