What are the responsibilities and job description for the Prior Authorization Coordinator position at Brockton Home Health Care Agency LLC?
Position : Prior Authorization Coordinator
Reportsto : Director of Nursing
Revised : 01 / 20 / 2025
JobSummary : The Home CareScheduler supports the office manager and clinical manager in performing dailyoperational functions within Brockton Home Health Care office. Primary dutiesinclude scheduling (communicating shift assignments to caregivers and clients),and HR / payroll management. The ideal candidate has previous experience workingin a customer service or administrative role, preferably in the health care or home health industry, and experience in caregiving.
About Brockton Home Health Care
Brockton Home Health Agency is aMedicaid and Medicare certified in Massachusetts and accredited by the JointCommission - Accreditation of Healthcare Organizations (JCAHO). Our mission isto provide each client and family with a sense of comfort, knowing they arebeing cared for by professionals that are exceptional in their field and whoare innately invested in the well-being of others
Highlights :
- Brockton Home Health Care offers a comprehensive benefits plan that includes the following :
- Paid time off,
- 401k, Roth IRA
- Direct deposit.
- Health Insurance
- Dental Insurance
- Vision Insurance
- Mileage reimbursement for all field travel.
- Great environment to work
Qualifications :
Responsibilities :
Request, track, andobtain prior authorizations from insurance carriers / third party authorizationcompanies within a reasonable time frame.
Contact insurance carriers to verify patient'sinsurance benefits and requirements specific to the requested radiologyprocedures.
Follow up with insurance provider'sauthorization companies prior to services being performed to secure priorauthorization.
Work closely with referring Insurance providers,Physician office, Hospitals, Health centers and communities to obtain necessarydata needed to submit for prior authorization.
Maintains a level of productivity suitable forthe department
Communicate anyinsurance changes or trends back to management and the scheduling team
Work closely with clinicalteam, schedulers and Referrals department
Ensure compliancewith federal and state regulations regarding Home Health Care submissions andquality assurance standards.
Participate in careplanning meetings to discuss resident needs and coordinate appropriateinterventions.
Facilitatecommunication between departments to ensure continuity of care, particularlyfor patients transitioning from critical care or home care settings.
As an accredited, regulated,certified, and licensed home health care provider, Brockton Home Health Carecomplies with all state / local mandates.
Brockton Home Health Care, and its associated entitiesand joint venture partners, are Equal Opportunity Employers. All employmentdecisions are made on a non-discriminatory basis without regard to sex, race,color, age, disability, pregnancy or maternity, sexual orientation, genderidentity, citizenship status, military status, or any other similarly protectedstatus in accordance with federal, state and local laws. Hence, we stronglyencourage applications from people with these identities or who are members ofother marginalized communities.
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