Home Health Authorization Specialist

Home Health Authorization Specialist

Employment Type: Full time

Shift: Monday-Friday 8:30 a.m.-5:00 pm EST rotating weekends & holidays

Build a Career. Make a Difference. Love Where You Work.

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 frontend 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 per 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 collaborates 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.

What You Can Expect

• Consistent & Reliable Workloads
• Competitive RN Pay + Low-Cost Benefits
• Supportive, Nurse-Led Leadership
• Real Career Growth Opportunities
• Epic EHR System
• Fast, Respectful Hiring Process

What You Will Do

• Prepare and enter data into the appropriate software assuring the accuracy of the regulated client account following all regulations placed on the homecare agency.
• Timely follow up on pending authorizations to ensure payment of claims.
• Generates all authorization documentation needed to bill 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.
• 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. Investigates 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.
• Acts independently and responsibly to perform duties on a consistent basis and in a timely manner.
• Acts as liaison between physician offices, THAH Service Center and the agency to assure timely billing with appropriate documentation.
• Ensures that services provided support continuous quality improvement, customer-oriented focus, and quality client care outcomes.

Benefits

• Day 1 Benefits - Health, dental and vision insurance
• Work Today Get Paid Tomorrow
• Employee Referral Reward Program
• Short and long-term disability
• Tuition Reimbursement
• 403b
• Generous paid time off
• Comprehensive orientation

Minimum Qualifications

• The incumbent can 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 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.

About Trinity Health At Home Southeast Michigan

Trinity Health At Home Southeast Michigan is a trusted member of Trinity Health At Home, a national home care, hospice and palliative care organization serving communities across 11 states. As a faith-based, not-for-profit agency, we are committed to caring for patients and families in the place they feel most comfortableat home. Our services include skilled nursing, physical, occupational and speech therapy and medical social work.

We are:

• Medicare-Certified
• Joint Commission Accredited
• A Reputation.com 800 Award Winner 2025 & 2026

Learn more at TrinityHealthAtHome.org/Michigan.

Ready to Apply?

Take the next step in your nursing career today. Apply now and discover why nurses choose to start, grow and stay with us.

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.