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AgeRight
Eligibility & Authorization Coordinator
Entry-Level JobVerifiedNo experience needed
Career Insights for Eligibility Specialist
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Based on Oregon data
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What they do
An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.
$57,921 / year median in Oregon
+18% projected growth
Job Description
Overview Home Health Eligibility & Authorization Coordinator Milwaukie, OR P osition Summary Coordinates insurance verification, payer eligibility review, prior authorizations, and documentation requirements to ensure timely admission and continuation of home health services. Essential Duties and Responsibilities Verify insurance eligibility and benefits prior to admission. Obtain and track prior authorizations and recertifications. Review referrals for payer requirements and coverage criteria. Coordinate with referral sources, clinicians, and payers. Maintain authorization logs and expiration dates. Resolve authorization denials and request additional documentation. Support timely intake processing and patient admission. Ensure compliance with CMS, Medicare, Medicaid, and commercial payer requirements. Maintain accurate records in EMR systems. Generate reports related to authorization status and payer trends. Qualifications High school diploma required; associate or bachelor degree preferred. Experience in home health intake, insurance verification, authorizations, or healthcare administration preferred. Knowledge and Skills Knowledge of Medicare, Medicaid, managed care, EMR systems, payer regulations, communication, organization, and problem-solving skills. Be open to cross-training on the other positions under the intake department. May other tasks will be asked, added or removed from this job description based on the agency needs. Performance Expectations Timely authorization processing, accurate eligibility verification, reduced authorization denials, regulatory compliance, strong customer service, and effective communication. AgeRight Care at Home provides individualized and comprehensive levels of in-home assistance, with a goal to help keep patients where they want to be for as long as possible. AgeRight Care at Home is part of Marquis Companies and Consonus Healthcare. We are connected as a network of facilities that provide assisted living, long term care, post-acute rehab, as well as rehab and pharmacy services to residents in Oregon, Nevada and California. These connections and resources provide employees of AgeRight the ability grow and pursue a career in healthcare. EEO Statement "Be here. Be you." For more than 30 years, AgeRight has been serving seniors and welcoming staff of all backgrounds, skills, and perspectives. The Marquis family of companies offer a rich heritage of embracing differences and honoring individuality. We've continued to grow in our appreciation of diversity in the workplace. We know it builds strength, drives innovation, and brings valuable new perspectives and energy. We're committed to making our workforce an even greater reflection of the people and communities we serve, and we are honored our employees have chosen to work at Marquis, Consonus and AgeRight. Everything we do as a company is driven by our mission to help those we serve, and each other, live the best rest of our lives. That means you being you - without apology or compromise. We value your every uniqueness and continue to curate, nurture, and sustain an inclusive culture. It's the foundation of who we are and the evolution of our collective future.