Home Health Prior Authorization Specialist

Alternate Solutions Health Network

Posted 3 months ago

Full Time

Kettering, Ohio

In Person

Smart Summary

Responsibilities

Secure medical authorizations from third-party commercial and government payers for post-acute services. Coordinate with clinical staff, medical offices, and insurance providers to ensure seamless patient care and eligibility tracking.

Qualifications

You have a high-school diploma or equivalent and possess a strong understanding of medical billing and insurance processes. You are proficient in Microsoft Excel, Word, and Outlook, with excellent communication and problem-solving skills to effectively manage patient authorizations and interact with various stakeholders.

Must Have Skills for ATS

Microsoft Excel

Microsoft Word

Microsoft Outlook

Peachtree

HCHB

EPIC

Job Description

Our culture and people are what set us apart from other post-acute care providers. We’re dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY.               

Monday - Friday, 8:15am - 5pm

*This position is located in our Kettering office*

HOW YOU'LL MAKE A DIFFERENCE:
At Alternate Solutions Health Network, we care for patients where they spend the majority of their time – in their homes. Today we care for patients who need skilled home care and hospice services. You won’t find our brand in many places because we partner with health systems, jointly running home health and hospice agencies that use their brand. This is part of our strategy. By being part of the health system team, we can ensure each patient has a well-coordinated care plan that remains consistent whether the patient is seeing their primary care physician, receiving treatment in a hospital, or under our care in the home. 

As an Authorization Specialist, you will take the lead in securing medical authorizations from third party payers (commercial and government) for post-acute services. The Authorization Specialist will be instrumental in obtaining written documentation, tracking, prioritizing and reporting outcomes of each authorization request. 

WHAT WE OFFER:
We provide medical, dental, and vision insurance with flexibility for you to select what works best for you. Eligible teammates receive paid time off and may participate in the 401K, if they choose. Historically the company has matched 401K contributions which helps build your nest egg even faster. Finally, our benefit program includes company paid life, disability insurance, and a robust Employee Assistance Program.

HOW YOU'LL WORK:
You will interface directly with clinical staff, medical offices and insurance payors to ensure a seamless process to the patients receiving post-acute health care services. 

MAJOR AREAS OF RESPONSIBILITY: 

  • Customer Service: Communicates with patients, employees and vendors regarding services.  Assists patients, their families and co-workers in understanding authorizations and eligibility

  • Operations: Checks eligibility for all payor types, assumes responsibility for all patient authorizations. Collects and records accurate patient information.

  • Compliance: Understands and practices agency policies and procedures and continually improves practices.  Able to follow all legal rules and regulations

HARD & SOFT SKILLS:

  • Excellent communicator with a positive attitude.

  • Patience is a virtue when working with patients, families, physicians, and coworkers.

  • Attention to detail is critical, as is being observant and following directions.

  • Proficiency in Microsoft Excel, Word, and Outlook. Experience with Peachtree, HCHB and EPIC is preferred. Ability to learn new systems.

  • Problem solving and create solutions to drive to a course of action.

 
REQUIREMENTS:

  • High-School graduate or equivalent.  Associates Degree preferred.  

  • 1 year of billing insurance experience in a health care environment preferred.

  • Capable of all physical demands.

City: Kettering, OH

#INDASHN3

We’ll help you put your passion for patient care to work.  Apply today!

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

We are an Equal Opportunity Employer.

Alternate Solutions Health Network

We’re building partnerships and transforming care. Alternate Solutions Health Network was founded in 1999 by David and Tessie Ganzsarto. We collaborate with health systems in joint venture partnerships to create a post-acute care solution, delivering efficient centralized operations and utilizing a best-in-class software platform. ASHN will never ask, nor require a candidate to provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from ASHN or affiliate, please contact jennifer.sanchez@ashealthnet.com to validate the request. Our Vision Story: Inspiring Care at Home At Alternate Solutions Health Network, we’re not just delivering care—we’re building bridges. Bridges between health systems and home health, between clinicians and their passion for caregiving, and between patients and the lives they long to lead. At ASHN, our purpose is simple yet profound: Inspiring care at home. We believe on the power of people, and you are the heart of our mission. Culture of Care At ASHN, you're part of a team that truly cares. We support your growth with mentorship, leadership development, and a sense of belonging. Care with a Purpose As a leader in the home health industry, you'll deliver dignity, independence, and hope to those who need it most. Your work inspires and transforms lives. Care that Connects By caring for patients in their homes, you create meaningful connections and provide deeply personal, heartfelt care. Caring Made Flexible: Your Career, Your Way Life is unpredictable and we get that. With flexible schedules, pay-per-visit earnings, and room to grow, your career works for you.
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