Employment Type:
Full time
Shift:
Description:
Home Health Authorization Specialist
Trinity Health At Home
As a Home Health Authorization Specialist, you will be responsible and accountable for the processing of all THAH authorization documentation meeting HCFA/MCC/JCAHO regulations and guidelines. Primary responsibilities include processing all front[1]end documentation needed to meet third party payer authorization deadlines assuring accurate billing. In addition, monitors all accounts for ongoing authorization needs to ensure optimal reimbursement and compliance with agency policy. This position works closely with the THAH insurance team and THAH Collection analysts in the tracking of authorizations and resolution of problematic billing issues. Monitors pending authorizations report and collaborate with both the clinical and revenue cycle team to review and resolve pending claims to ensure timely payment. Duties may be accomplished in a remote work environment.
Why You'll Love Working With Us
Start Here... Grow Here... Stay Here!
We don't just offer jobs-we build long-term careers. Many of our nurses have grown into leadership roles because we invest deeply in your development, well-being, and success.
Here's what you can look forward to:
Consistent, Predictable Schedules
Enjoy reliable workloads with guaranteed hours-no guessing, no stress.
Competitive Pay & Affordable Benefits
Access comprehensive, low-cost benefits and compensation that truly reflects your expertise.
Supportive, Visible Leadership
You'll always feel backed by leaders who understand home care and are committed to helping you excel.
Clear Pathways for Career Growth
Every leader on our team began in a field role-you can grow here, too.
Epic EMR System
Experience streamlined charting and communication with one of the most trusted systems in healthcare.
Fast, Candidate-Friendly Hiring Process
Quick interviews and prompt offers-we respect your time.
Deeply Meaningful Work
Deliver one-on-one, relationship-driven care that makes a real difference in the lives of patients and families.
Essential Functions
Prepares and enters data into the appropriate software, assuring the accuracy of the regulated client account following all regulations placed on the homecare agency. Ensures that input of information is accurate and authorization is received timely for the submission of claims. Responds to all system issues by preparing documentation for the resolution center. Timely follow up on pending authorizations to ensure payment of claims.
Generates all authorization documentation needed to be billed in a timely manner assuring industry standards are met. Monitors and processes the Subsequent Authorizations workflow and reports daily to assure timely and clean billing.
Utilizing the CQI Process Improvement technique, responsible for implementing and monitoring changes to processes to ensure continued integrity of client accounts. Collaborates with the Intake Department to identify processes for improvement ensuring the accuracy of the authorization process.
Provides statistical feedback regarding the status of unbilled claims due to authorizations to THAH Revenue team on a weekly basis or as defined by policy.
Interfaces with THAH to resolve problems related to the processing of bills/claims. Investigate client accounts and provides any additional documentation required.
Seeks assistance of Clinical Team Leaders and/or Revenue Cycle Leaders with clinical data entry and/or billing problems.
Coordinates the flow of billing related paperwork between the branch and THAH Service Center. Works with the branch and THAH colleagues to identify areas of improvement related to authorization workflow. Actively participates in all billing conference calls between the agency and THAH
Minimum Qualifications
The incumbent is able to articulate and demonstrate a commitment to the mission, vision and values of
Trinity Health and to inspire active support of these in others.
The preferred candidate will have a high school diploma or GED.
College business courses or an Associate's Degree is preferred, or four to six years of experience in a
medical billing office setting with a concentration on authorizations.
A strong knowledge of general business office functions, strong analytical and organizational skills and
microcomputer usage is required.
Incumbent must possess the following: ability to meet strict deadlines with high level of accuracy, ability to
prioritize multiple tasks in highly automated setting and possess strong interpersonal skills.
Ability to consistently demonstrate commitment to the mission and Organizational Code of Ethics, and
adhere to the Compliance
What We Offer
Medical, dental, and vision coverage starting Day One
Short- and long-term disability
403(b) retirement plan with employer match
Generous paid time off plus 7 paid holidays
Tuition reimbursement up to $5,250/year
Comprehensive onboarding and orientation program
About Trinity Health At Home
Trinity Health At Home is a national home care, hospice and palliative care organization serving communities throughout eleven states. As a faith-based, not-for-profit agency, we serve patients and families in the comfort of home, offering skilled nursing, therapy (physical, occupational, speech) and medical social work.?We are Medicare-certified and accredited by The Joint Commission. Learn more about us at? TrinityHealthAtHome.org/Michigan .
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.
EOE including disability/veteran
