Home Health QA Specialist- RN

Are you looking to make a difference in patients’ lives with a company that values your expertise? Join us in our mission of delivering compassionate healthcare where it matters most –– at home. Pinnacle Home Care, Florida’s largest Medicare-certified home health provider, has been delivering high-quality, patient-centered care for over two decades, and we’re looking for an Authorization Coordinator to join our award-winning team.

Coordinate and process patient authorization to completion with precision, detail, and accuracy. Serve in a highly patient-focused role that works directly with our branches, clinicians, Case Managers, Care Coordinators, Physicians/ PCP(s), insurance representatives, outside vendors, and other medical personnel. Communicate professionally relevant information to the appropriate teams. Transmit appropriate documents to support the authorization request throughout the life cycle of the patient treatment. Effectively manage authorization throughout the course of a patient episode to ensure that the patient’s treatment coincides with the authorization provided by the Insurance carrier. Monitor communications including faxes, emails and phones calls throughout the day to update patient authorization status and adhere to any failed communications or requests for additional information to process authorization. Identify and reconcile complex authorization issues in a timely manner. Meet productivity goals assigned by Authorization Leadership. Adhere to federal, state, and agency regulations and policies to maintain confidentiality of patients and agency information per HIPPA requirements.