Prior Authorizations Specialist

Job Description

Job Description

a growing Certified Home Health Agency (CHHA) dedicated to delivering exceptional, compassionate care to our patients across counties. We are expanding our administrative and clinical operations team and are seeking a skilled Authorization Specialist with strong knowledge of Homecare Homebase (HCHB) to support our continued growth.

The Authorization Specialist is responsible for securing and maintaining authorizations for all home health services, ensuring timely and accurate submission of required documentation, and collaborating with payors, clinicians, and internal departments. This role is essential to smooth care delivery, compliance, and optimized reimbursement.

• Obtain, verify, and maintain authorizations for CHHA services including skilled nursing, therapy, HHA, and additional care services.

• Process all authorization requests through Homecare Homebase (HCHB) with accuracy and efficiency.

• Communicate with insurance companies, MLTCs, Managed Care plans, Medicare Advantage, and other payors to ensure timely approvals.

• Track authorization statuses, expirations, and visit utilization to avoid lapses in coverage.

• Collaborate with intake, scheduling, clinical teams, and billing to ensure compliance with care plans and payor requirements.

• Monitor daily reports and resolve authorization issues proactively.

• Ensure documentation meets payor guidelines and CHHA regulatory standards.

• Maintain detailed records and support audits as needed.

• Minimum 1–2 years of experience as an Authorization Specialist in a CHHA or home care environment.

• MUST have hands-on experience in Homecare Homebase (HCHB).

• Strong understanding of CHHA workflows, payor requirements, and utilization practices.

• Excellent communication and follow-up skills with payors and internal teams.

• Highly organized with strong attention to detail.

• Ability to work in a fast-paced environment and manage multiple priorities.

• Familiarity with Medicare, Medicaid, MLTC, and Managed Care authorizations.

• Experience with visit utilization management.

• Knowledge of New York State CHHA regulations 

• Bilingual language skills

• Competitive salary

• Health, dental, and vision insurance

• PTO + paid holidays

• Professional growth opportunities

• Supportive team environment