Service Authorization Specialist (Homecare Insurance Authorization)

Overview

Make a Difference Behind Every Patient's Care

Are you detail-oriented, organized, and passionate about helping patients receive the care they need? Do you enjoy navigating insurance requirements, solving problems, and working collaboratively to keep operations running smoothly?

We are seeking a Service Authorization Specialist to join our Revenue Cycle Management (RCM) team! In this role, you will play a vital part in ensuring patients receive timely, uninterrupted home care and home health services by securing and managing insurance authorizations. Your work will help support quality patient care, strengthen reimbursement processes, and prevent avoidable billing delays and denials.

If you thrive in a fast-paced healthcare environment, enjoy working with insurance payers, and take pride in accuracy and follow-through, we encourage you to apply!

Responsibilities

What You'll Do

As our Service Authorization Specialist, you will serve as a key connection between insurance payers, clinical teams, intake, scheduling, and billing to help ensure services are authorized and reimbursement requirements are met.

Your responsibilities will include:

• Manage Service Authorizations: Review referrals and service requests to identify authorization requirements and submit initial authorization and reauthorization requests to Medicare Advantage, Medicaid Managed Care, commercial insurance, Veterans Affairs (VA), Workers' Compensation, and other third-party payers.
• Verify Insurance Coverage: Confirm patient eligibility, benefits, coverage limitations, and payer-specific requirements to support appropriate service delivery.
• Monitor Authorization Status: Proactively follow up on pending requests, track approval timelines, and address outstanding issues to help prevent delays in care.
• Maintain Authorization Compliance: Monitor authorized visits, service units, and expiration dates to help ensure services remain appropriately authorized.
• Collaborate Across Teams: Partner with Intake, Clinical Operations, Scheduling, and Billing to communicate authorization approvals, denials, changes, and potential barriers to service.
• Coordinate Documentation: Ensure required clinical documentation is complete, accurate, and submitted within payer timelines.
• Prevent Denials and Revenue Delays: Identify authorization gaps and reimbursement risks, escalate concerns appropriately, and help secure required approvals before services are rendered.
• Maintain Accurate Records: Document authorization details, payer communications, approval dates, and expiration dates in electronic medical record (EMR) and billing systems.
• Navigate Payer Resources: Use insurance portals and other communication channels to submit requests, track status, and resolve authorization questions.
• Support Denial Resolution: Assist with appeals and reconsideration requests related to authorization denials, as needed.
• Stay Current and Improve Processes: Monitor payer policy changes, communicate operational impacts, and contribute to initiatives that improve turnaround times, accuracy, and revenue cycle performance.

Qualifications

What We're Looking For

We are looking for someone who combines strong organizational skills with a proactive, solutions-oriented approach. The ideal candidate understands the importance of timely authorizations and recognizes how accurate, consistent follow-through supports both patient care and the financial health of the organization.

Required Qualifications

• High school diploma or GED.
• At least 2 years of experience in healthcare authorizations, patient intake, insurance verification, or revenue cycle management.
• Working knowledge of Medicare, Medicaid, managed care, and commercial insurance plans.
• Understanding of insurance eligibility, payer authorization requirements, and authorization workflows.
• Strong attention to detail, organizational skills, and the ability to manage multiple priorities.
• Proficiency with EMR systems, payer portals, and Microsoft Office applications.
• Excellent written and verbal communication skills.
• Ability to collaborate effectively with multiple departments and follow through on time-sensitive requests.

Preferred Qualifications

• Associate's or bachelor's degree in Healthcare Administration, Business Administration, or a related field.
• Experience in home health, home care, hospice, or other post-acute care settings.
• Revenue Cycle Management experience.
• Familiarity with Medicare Advantage authorization processes.
• Experience supporting authorization appeals, denial prevention, or reimbursement improvement initiatives.

What Success Looks Like

In this role, your contributions will help ensure authorizations are obtained accurately and on time, services continue without avoidable authorization interruptions, and preventable reimbursement issues are minimized.

Success will be reflected in:

• Timely submission of initial authorizations and reauthorizations.
• Strong authorization approval rates.
• Reduced denials related to missing, incomplete, or expired authorizations.
• Efficient follow-up and authorization turnaround times.
• Accurate authorization documentation and data entry.
• Proactive identification of authorization issues that could affect patient care or reimbursement.

The Qualities That Will Help You Succeed

• Attention to Detail: You take pride in maintaining accurate records and catching potential issues before they become problems.
• Problem-Solving: You approach payer challenges proactively and work toward timely resolutions.
• Organization and Time Management: You can prioritize competing deadlines and manage multiple authorization requests effectively.
• Communication and Collaboration: You build productive working relationships and communicate important updates clearly.
• Revenue Cycle Awareness: You understand how authorization accuracy and timeliness affect reimbursement and financial performance.
• Compliance Mindset: You recognize the importance of following payer requirements, maintaining documentation, and supporting compliant operations.

Why This Role Matters

Every authorization represents an important step in connecting patients with the services they need. As a Service Authorization Specialist, you will help bridge the gap between payer requirements and patient care, supporting continuity of services while protecting the organization from preventable denials and revenue loss.

If you are ready to bring your healthcare experience, attention to detail, and commitment to operational excellence to a team where your work makes a meaningful difference, we invite you to apply for the Service Authorization Specialist position today!