Authorization Specialist

Job Description

Job DescriptionAuthorization Specialist

Location: Snellville, GA & Bozeman, MT
Employment Type: Full-Time

Position Overview

The Authorization Specialist plays a critical role in supporting home care operations by ensuring timely and accurate verification of insurance eligibility and payer authorization for services. This position works closely with branch management and clinical teams to ensure compliance with payer requirements and continuity of care.

Reports To:

Business Manager

Key Responsibilities

• Verify initial and ongoing insurance eligibility and authorization for current and prospective home care clients

• Communicate eligibility and authorization details to the Clinical Manager, Business Manager, and other relevant staff

• Enter accurate authorization information into designated systems

• Notify management of any service coverage issues or denials

• Conduct timely re-authorization and eligibility checks

• Monitor authorizations to ensure alignment with service quantity, duration, and payer requirements

• Ensure timely and appropriate processing of authorization requests

• Send necessary correspondence to payers and document communications

• Maintain effective, professional communication with clients, insurance payers, and internal team members

• Preserve the confidentiality of all client, family, and staff information

• Serve as a resource on insurance requirements, maintaining current knowledge through ongoing training

• Demonstrate initiative and organization in managing workload and priorities

• Participate in after-hours on-call rotation to support client care continuity and staffing resolutions

• Perform other related duties as assigned by branch leadership

Qualifications

• High school diploma or equivalent (Associate’s degree in healthcare administration or related field preferred)

• Minimum of 1–2 years of experience in insurance verification, medical billing, or home health authorization

• Familiarity with payer-specific authorization procedures (e.g., Medicare, Medicaid, private insurers)

• Strong attention to detail and ability to manage multiple authorizations concurrently

• Excellent verbal and written communication skills

• Proficient with standard office and EMR systems

Physical/Environmental Requirements

• Primarily desk-based with frequent use of telephone and computer systems

• Occasional bending, stretching, and lifting of up to 25 lbs; up to 50 lbs occasionally

• Ability to work flexible hours as needed, including occasional extended shifts

• Must be able to operate both standard and specialized office equipment