Home Health Insurance Authorization Specialist

Become a part of our caring community

This is a full-time remote position scheduled for 40 hours a week, 5 days a week. The standard schedule is Monday-Friday from 7:30am-4:00pm CST / 8:30am-5:00pm EST. Some flexibility may be required based on business needs.

As a Home Healthcare Insurance Authorization Specialist, you will report directly to the Authorization Supervisor and be responsible for:

• Daily audit of admission, discharge, and other source documentation to ensure revenue is recognized appropriately and all conditions of payment are met.
• Verify patient eligibility and payor coverage guidelines to ensure all necessary information is secured for timely, accurate revenue recognition.
• Weekly generation of site revenue and resolution of batch errors and bill holds.
• Weekly communication with site leadership regarding outstanding documentation or issues impacting revenue.
• Prepare and submit invoices to Accounts Payable and perform follow-up to ensure accurate, timely payments.
• Prepare, submit, and follow up on authorization and re-authorization requests according to state and commercial payor guidelines.
• Coordinate, review, and analyze documentation supporting Medicare, Medicaid, and commercial payer requirements.
• Ensure internal controls and policies are followed in accordance with accounts receivable requirements.
• Ensure all payer requirements are met, including pre-certifications, notifications, and level of care changes.
• Alert site team members regarding late or missing billing documentation.
• Establish and maintain positive working relationships with sites, nursing facilities, and AR teams.
• Maintain strict confidentiality of patient/client and agency information.
• Maintain accurate, up-to-date information for all vendor and nursing facility contracts.
• Ensure compliance with local, state, and federal laws, Medicare regulations, and company policies.
• Participate in special projects and perform other duties as assigned.
• Assist with training new associates and re-educating revenue teams.
• Act as a subject matter expert for revenue generation and system issues.
• Coordinate work in an associate's absence to maintain departmental standards.

Required Experience and Skills

• One or more years of related experience and/or training preferred.
• Two or more years of Home Healthcare or Medical Office experience preferred.
• Knowledge of insurance reimbursement and authorization processes.
• Proficiency in Microsoft Office (Word, Excel, Outlook).
• Two years of college preferred.

Technical Requirements for Remote Work

To work effectively, your home internet must meet these criteria:

• Minimum download speed of 25 Mbps and upload speed of 10 Mbps (wired cable or DSL suggested).
• Satellite, cellular, and microwave connections require leadership approval.
• Employees in CA, IL, MT, or SD will receive a bi-weekly internet expense payment.
• Telephone equipment will be provided.
• Must work from a dedicated, distraction-free space to protect PHI/HIPAA information.
• Occasional travel to Humana offices for training or meetings may be required.

Compensation and Benefits

• Scheduled Weekly Hours: 40
• Pay Range: $43,000 - $56,200 per year (varies based on experience, location, and skills).
• Benefits: Includes medical, dental, vision, 401(k), paid time off, parental/caregiver leave, disability, and life insurance.

About Us

CenterWell Home Health specializes in personalized, comprehensive home care for patients managing chronic conditions or recovering from injury, illness, or surgery. As part of Humana, we are committed to high-quality, integrated healthcare that puts patients at the center of everything we do.

Equal Opportunity Employer

Humana is an equal opportunity employer and does not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status.

Application Deadline: 06-18-2026