Location Detail:

76 Batterson Park Farmington (10631)

Shift Detail:

Monday thru Friday with rotating weekends and holidays Work where every moment matters. Every day, over 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network as an Authorization Specialist Lead III. Hartford HealthCare at Home, the largest provider of homecare services in Connecticut, has been fulfilling our mission for more than 115 years. Our Person-Centered Care Model allows our colleagues to learn and grow within our organization, all while providing integrated support to the patient. As part of Hartford HealthCare, we leverage cutting edge technology to provide quality care in our client's home. Most importantly, our colleagues are appreciated for the real differences they make in both the lives of their clients and their clients' families. Under the direction of the Prebilling and Authorization Manager, the Authorization Specialist Lead III serves as the senior resource and subject matter expert for Home Health and Hospice authorization and eligibility processes. This role provides operational leadership, quality oversight, training, auditing, and support to Authorization Specialists while ensuring timely and accurate verification of insurance benefits, prior authorizations, and payer requirements. The position partners closely with Intake, Clinical Operations, Billing, Revenue Cycle, and agency leadership to support compliance, minimize reimbursement risk, and ensure timely billing and reimbursement.

Responsibilities:

Perform and oversee complex insurance eligibility verification, benefit reviews, prior authorization acquisition, and authorization renewals. Ensure authorizations are obtained, documented, tracked, and maintained in accordance with payer requirements. Serve as the primary escalation resource for authorization issues, payer concerns, and reimbursement barriers. Provide day-to-day leadership, guidance, training, coaching, and workflow support to Authorization Specialists, including onboarding and competency development. Collaborate with Intake, Clinical Operations, Billing, Revenue Cycle, and agency leadership to resolve issues and improve workflow efficiency. Conduct audits of authorization and eligibility processes to ensure accuracy, compliance, and quality standards. Monitor denial trends, reimbursement barriers, and payer requirements, identifying opportunities for process improvement. Maintain current knowledge of Medicare, Medicaid, Medicare Advantage, Managed Care, and commercial payer requirements impacting Home Health and Hospice services. Participate in special projects, process improvement initiatives, policy development, and other duties as assigned. Maintain confidentiality, professionalism, and effective communication with payers, patients, staff, and operational partners. Qualifications Required Qualifications High School Diploma or GED. Minimum of one (1) year of Home Health and/or Hospice experience, or one (1) year of experience in insurance verification, prior authorizations, or related healthcare functions. Knowledge of healthcare reimbursement, eligibility verification, and authorization processes. Strong communication, organizational, analytical, and problem-solving skills. Proficiency with Microsoft Office applications and reporting tools. Ability to manage multiple priorities and work effectively in a fast-paced environment. Preferred Qualifications Associate's degree in healthcare administration, Business, or a related field. Three (3) or more years of experience in healthcare insurance verification, prior authorizations, revenue cycle, intake, billing, or related functions. Advanced knowledge of Home Health and Hospice payer requirements and reimbursement guidelines. Strong understanding of Medicare, Medicare Advantage, Medicaid, VA, and commercial insurance plans. Experience conducting audits, monitoring compliance, and supporting quality improvement initiatives. Experience serving as a lead resource, trainer, or subject matter expert. Experience with Homecare Homebase (HCHB) and payer portals. Demonstrated ability to collaborate effectively with clinical, operational, intake, billing, and revenue cycle teams. We take great care of careers With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge - helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving colleagues- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.