VitalCaring Group
Insurance Verification & Authorization Specialist
VitalCaring Group, Dallas, Texas, United States, 75215
Insurance Verification & Authorization Specialist
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Insurance Verification & Authorization Specialist
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VitalCaring Group As we expand our services in new and existing markets, we're looking for an Insurance Verification and Authorization Specialist who shares our values of being Trustworthy, Capable, Compassionate, Proactive, and called to serve. The Insurance Verification and Authorization Specialist verifies patient insurance eligibility and securing prior authorizations for home health services using Homecare Homebase (HCHB). This role is part of a centralized team that supports multiple branches to ensure timely initiation and continuation of care, proper documentation, and compliance with payer requirements. The specialist plays a vital role in minimizing reimbursement delays and ensuring accurate data is captured in HCHB. Responsibilities
Conduct insurance verification through payer portals, phone calls, and HCHB’s integrated tools for all new referrals and ongoing patients. Initiate and obtain prior authorizations for home health services including nursing, therapy, and aide services as required by payers. Accurately enter and maintain insurance, authorization, and eligibility information within the HCHB system in real-time. Review patient intake information to ensure payer requirements are identified and addressed early in the admission process. Collaborate with intake, clinical staff, case managers, and billing teams to resolve authorization-related issues promptly. Follow up proactively with insurance companies to ensure timely processing of authorizations and appeals. Stay current on payer-specific authorization protocols, documentation requirements, and changes to coverage policies affecting home health. Ensure compliance with HIPAA, Medicare Conditions of Participation, and other regulatory standards. Maintain organized and auditable records of all insurance and authorization communications and decisions within HCHB and agency systems. Skills for Success
Fully remote during agency operating hours Ideal candidate should reside in Texas, Louisiana, Mississippi, Florida, or Alabama Regular use of computers, phones, and HCHB software system Flexibility and the ability to adapt to frequent changes in payer rules and agency workflows Prolonged sitting required, with the ability to operate office equipment; physical requirements may include lifting up to 50 pounds occasionally Ability to grasp, pull, push, carry, or manipulate objects; strong hand-eye coordination Attention to detail and ability to distinguish small details in data and documents Ability to concentrate on fine detail with periodic interruptions Ability to remain calm and courteous under stress Ability to meet strict turnaround times and communicate clearly in person and by phone Excellent computer software skills; working knowledge of MS Office, especially Excel Ability to work effectively under minimal supervision and maintain confidentiality Must have and maintain a valid Driver’s License and proof of auto liability insurance Experience To Deliver On Our Mission
High school diploma or equivalent required; associate degree or higher preferred Minimum 2 years of experience in home health authorization/eligibility processes Proficiency in Homecare Homebase (HCHB) strongly preferred Strong understanding of traditional Medicare, Medicare Advantage, and commercial insurance guidelines Experience navigating payer websites/portals (e.g., Availity, Waystar, Palmetto, etc.) Detail-oriented with excellent organizational and follow-up skills Effective communication and customer service skills with internal teams and external payers Ability to multitask in a high-volume, fast-paced remote or office environment Come home to VitalCaring where you will find your passion, find your people, and find yourself again. Together we can transform lives and foster hope through genuine caring. Explore your future with VitalCaring today.
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Join to apply for the
Insurance Verification & Authorization Specialist
role at
VitalCaring Group As we expand our services in new and existing markets, we're looking for an Insurance Verification and Authorization Specialist who shares our values of being Trustworthy, Capable, Compassionate, Proactive, and called to serve. The Insurance Verification and Authorization Specialist verifies patient insurance eligibility and securing prior authorizations for home health services using Homecare Homebase (HCHB). This role is part of a centralized team that supports multiple branches to ensure timely initiation and continuation of care, proper documentation, and compliance with payer requirements. The specialist plays a vital role in minimizing reimbursement delays and ensuring accurate data is captured in HCHB. Responsibilities
Conduct insurance verification through payer portals, phone calls, and HCHB’s integrated tools for all new referrals and ongoing patients. Initiate and obtain prior authorizations for home health services including nursing, therapy, and aide services as required by payers. Accurately enter and maintain insurance, authorization, and eligibility information within the HCHB system in real-time. Review patient intake information to ensure payer requirements are identified and addressed early in the admission process. Collaborate with intake, clinical staff, case managers, and billing teams to resolve authorization-related issues promptly. Follow up proactively with insurance companies to ensure timely processing of authorizations and appeals. Stay current on payer-specific authorization protocols, documentation requirements, and changes to coverage policies affecting home health. Ensure compliance with HIPAA, Medicare Conditions of Participation, and other regulatory standards. Maintain organized and auditable records of all insurance and authorization communications and decisions within HCHB and agency systems. Skills for Success
Fully remote during agency operating hours Ideal candidate should reside in Texas, Louisiana, Mississippi, Florida, or Alabama Regular use of computers, phones, and HCHB software system Flexibility and the ability to adapt to frequent changes in payer rules and agency workflows Prolonged sitting required, with the ability to operate office equipment; physical requirements may include lifting up to 50 pounds occasionally Ability to grasp, pull, push, carry, or manipulate objects; strong hand-eye coordination Attention to detail and ability to distinguish small details in data and documents Ability to concentrate on fine detail with periodic interruptions Ability to remain calm and courteous under stress Ability to meet strict turnaround times and communicate clearly in person and by phone Excellent computer software skills; working knowledge of MS Office, especially Excel Ability to work effectively under minimal supervision and maintain confidentiality Must have and maintain a valid Driver’s License and proof of auto liability insurance Experience To Deliver On Our Mission
High school diploma or equivalent required; associate degree or higher preferred Minimum 2 years of experience in home health authorization/eligibility processes Proficiency in Homecare Homebase (HCHB) strongly preferred Strong understanding of traditional Medicare, Medicare Advantage, and commercial insurance guidelines Experience navigating payer websites/portals (e.g., Availity, Waystar, Palmetto, etc.) Detail-oriented with excellent organizational and follow-up skills Effective communication and customer service skills with internal teams and external payers Ability to multitask in a high-volume, fast-paced remote or office environment Come home to VitalCaring where you will find your passion, find your people, and find yourself again. Together we can transform lives and foster hope through genuine caring. Explore your future with VitalCaring today.
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