Weekend Managed Care Coordinator

Weekend Managed Care Coordinator Concierge Home Care | Remote-Florida Residence PRN | EVERY Saturdays & Sundays | 8:30 AM to 5:00 PM  Managed Care & Authorization Focus   Help Patients Access the Care They Need At Concierge Home Care, we believe in the power of home health care to change lives—for patients and team members alike. Our mission, “Caring for people who care for people,” drives everything we do. As a Managed Care Coordinator, you will play a critical role in helping patients receive the home health services they need by ensuring insurance benefits are verified, authorizations are obtained, and required payer processes are completed accurately and on time. This position is part of our Intake Department and works closely with Operations, Sales, referral sources, and insurance payors.   Why Team Members Choose Concierge Home Care Meaningful Work Help ensure patients have timely access to home health services Play an important role in the coordination of patient care Work collaboratively with Operations, Sales, Intake, providers, and payors Be part of a growing healthcare organization focused on quality patient care Professional Growth Structured onboarding and training Exposure to multiple insurance plans and managed care processes Opportunities to develop expertise in healthcare authorizations and payer relations Opportunities for professional growth within Intake and Operations Supportive leadership and collaborative team environment   Your Role as a Managed Care Coordinator The Managed Care Coordinator is responsible for managing the insurance verification and authorization process for new and existing home health patients. Success in this role requires strong attention to detail, excellent follow-through, and a thorough understanding of insurance authorization processes. You will help ensure that authorization requirements are identified, completed, documented, and maintained throughout the patient's episode of care. Responsibilities Include Insurance Verification & Eligibility 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 Authorization & Reauthorization Obtain initial authorizations for home health services Monitor authorization status and expiration dates Obtain reauthorizations as required to support continued patient care Follow up with insurance companies and managed care organizations regarding pending authorizations Ensure authorization information is accurately documented within the EMR Maintain a consistent process to prevent authorization gaps Payor Communication Communicate directly with insurance companies, managed care organizations, and payer representatives Navigate payer portals and electronic authorization systems Submit required documentation and information to support authorization requests Follow up on outstanding requests and resolve authorization-related issues Maintain professional relationships with payer representatives Documentation & Compliance Maintain accurate and complete records of eligibility, benefits, authorizations, and reauthorizations Ensure payer requirements and authorization information are documented appropriately Protect confidential patient and insurance information in accordance with HIPAA regulations Follow company policies and established managed care processes Internal Collaboration Collaborate with the Intake team 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 impact patient acceptance Escalate authorization concerns or potential coverage issues appropriately Technology & Systems Our Managed Care team works with multiple electronic systems and payer platforms, including: Electronic Medical Record (EMR) systems Insurance verification platforms Payer portals Electronic authorization systems Healthcare referral and documentation platforms Experience navigating multiple EMR systems and insurance portals is highly preferred.   Qualifications Required 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 Knowledge of home health insurance authorization and reauthorization processes Familiarity with medical terminology Experience working with multiple EMR platforms Experience working with Medicare Advantage, managed care, Medicaid, commercial insurance, or other healthcare payors Experience working in a high-volume Intake or Managed Care environment   Join a Team That Cares At Concierge Home Care, our mission is simple: “Caring for people who care for people.” We believe great patient care starts with great team members. If you are experienced in insurance authorizations, eligibility, managed care, and payer communication and want to use those skills to help patients access the care they need, we would love to meet you.   Your application for employment may require successful completion of an AHCA Level 2 background screening. For more information regarding Care Provider Background Screenings conducted by the Clearinghouse, please visit: Florida Care Provider Background Screening Clearinghouse [https://info.flclearinghouse.com?utm_source=chatgpt.com] Every Saturday and Sunday