Lola Blankets is hiring an Insurance Verification & Authorization Specialist to join our team focused on ensuring patients receive the home health care they need. In this role, you will manage the verification and authorization process, working closely with clinical and intake teams to resolve issues and maintain compliance with payer and regulatory standards.
What You'll Do
- Conduct insurance verification through payer portals, phone calls, and HCHB’s integrated tools for all new referrals and ongoing patients.
- Initiate and obtain prior authorizations for home health services including nursing, therapy, and aide services as required by payers.
- Accurately enter and maintain insurance, authorization, and eligibility information within the HCHB system in real-time.
- Review patient intake information to ensure payer requirements are identified and addressed early in the admission process.
- Collaborate with intake, clinical staff, case managers, and billing teams to resolve authorization-related issues promptly.
- Follow up proactively with insurance companies to ensure timely processing of authorizations and appeals.
- Stay current on payer-specific authorization protocols, documentation requirements, and changes to coverage policies affecting home health.
- Ensure compliance with HIPAA, Medicare Conditions of Participation, and other regulatory standards.
- Maintain organized and auditable records of all insurance and authorization communications and decisions within HCHB and agency systems.
What We're Looking For
- High school diploma or equivalent.
- Minimum 2 years of experience in home health authorization/eligibility processes.
- Strong understanding of traditional Medicare, Medicare Advantage, and commercial insurance guidelines.
- Experience navigating payer websites/portals (e.g., Availity, Waystar, Palmetto).
- Detail-oriented with excellent organizational and follow-up skills.
- Effective communication and customer service skills with both internal teams and external payers.
- Ability to multitask in a high-volume, fast-paced remote or office environment.
- Must have and maintain a valid Driver’s License and proof of current valid auto liability insurance.
- Fully remote during agency operating hours.
- Ideal candidate should reside in Texas, Louisiana, Mississippi, Florida, or Alabama.
- Regular use of computers, phones, and the HCHB software system.
- Requires flexibility and the ability to adapt to frequent changes in payer rules and agency workflows.
- Requires the ability to concentrate on fine detail with frequent interruption; ability to focus attention on tasks for 10-20 minutes at a time on a continuous basis, 20-60 minutes on occasion.
- Requires the ability to remain calm and courteous under stress.
- Requires working under strict turnaround time guidelines to meet business needs.
- Requires ability to communicate clearly and make self-understood effectively in face-to-face interactions; articulate with accuracy to communicate using phone.
- Requires ability to hear and receive verbal instructions correctly, answer phones, communicate professionally in situations with some background noise.
- Requires ability to understand and relate to specific ideas one at a time and to the concepts behind specific ideas; ability to remember verbal and written tasks/assignments from a few hours to several day periods.
- Excellent computer software skills necessary to produce accurate documents and materials.
- Working knowledge of MS Office, Excel or similar software required.
- Requires ability to work effectively under minimal supervision; exercise excellent, sound professional judgment and maintain confidentiality.
Nice to Have
- Associate degree or higher.
- Proficiency in Homecare Homebase (HCHB) strongly preferred.
- Proficient knowledge of MS Office, Excel or similar software preferred.
Technical Stack
- Homecare Homebase (HCHB)
- MS Office, Excel
- Payer portals (Availity, Waystar, Palmetto)
Team & Environment
You will collaborate with intake, clinical staff, case managers, and billing teams.
Benefits & Compensation
- Medical, Dental & Vision
- Pharmacy Benefits
- Virtual & Mental Health Support
- Flexible Spending Accounts (FSAs) & Health Savings Account (HSA)
- Supplemental Health & Life Insurance
- 401(k) with Company Match
- Employee Referral Program
- Prepaid Legal Plans
- Identity Theft Protection
- Paid Time Off (6 weeks per year)
- Pet Insurance
- Tuition & Continuing Education Reimbursement
Work Mode
This role is fully remote during agency operating hours. The ideal candidate should reside in Texas, Louisiana, Mississippi, Florida, or Alabama.
Lola Blankets is an equal opportunity employer.
