Eligibility & Authorization Coordinator

About the Role

Coordinates insurance verification, payer eligibility review, prior authorizations, and documentation requirements to ensure timely admission and continuation of home health services.

Responsibilities

• Verify insurance eligibility and benefits prior to admission.
• Obtain and track prior authorizations and recertifications.
• Review referrals for payer requirements and coverage criteria.
• Coordinate with referral sources, clinicians, and payers.
• Maintain authorization logs and expiration dates.
• Resolve authorization denials and request additional documentation.
• Support timely intake processing and patient admission.
• Ensure compliance with CMS, Medicare, Medicaid, and commercial payer requirements.
• Maintain accurate records in EMR systems.
• Generate reports related to authorization status and payer trends.
• Be open to cross-training on other positions under the intake department.
• Perform additional tasks as needed based on agency requirements.

Requirements

• High school diploma required; associate or bachelor degree preferred.
• Experience in home health intake, insurance verification, authorizations, or healthcare administration preferred.

Skills

• Knowledge of Medicare, Medicaid, and managed care.
• Familiarity with EMR systems.
• Understanding of payer regulations.
• Strong communication, organization, and problem-solving skills.

Performance Expectations

• Timely authorization processing.
• Accurate eligibility verification.
• Reduced authorization denials.
• Regulatory compliance.
• Strong customer service.
• Effective communication.

About the Company

AgeRight Care at Home provides individualized and comprehensive levels of in-home assistance, with a goal to help keep patients where they want to be for as long as possible. AgeRight Care at Home is part of Marquis Companies and Consonus Healthcare. We are connected as a network of facilities that provide assisted living, long-term care, post-acute rehab, as well as rehab and pharmacy services to residents in Oregon, Nevada, and California. These connections and resources provide employees of AgeRight the ability to grow and pursue a career in healthcare.