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Reauthorization Specialist

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Arcadia Home Care and Staffing - an Addus family company

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Location:
United States , Frisco

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Category:
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Contract Type:
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Salary:

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Job Description:

The Reauthorization Specialist is responsible for managing all aspects of reauthorizations for client care. This includes re-verifying client eligibility, monitor insurance lifetime caps and prior authorization periods.

Job Responsibility:

  • Manage all aspects of reauthorizations for client care
  • Re-verify client eligibility
  • Monitor insurance lifetime caps and prior authorization periods
  • Process new intakes and reauthorization by reviewing referrals
  • Ensure all services are authorized within required time frame to prevent laps in care
  • Monitor authorization start and end date to proactively manage renewals and prevent expirations
  • Follow up on pending authorization and communicate updates to the branch
  • Accurately enter and update authorization detail in the system
  • Maintain complete, compliant, and well-organized patient records
  • Review documentation for accuracy and consistency prior to submission or scanning
  • Scan, upload and index authorization documents into the appropriate system and a timely manner
  • Handle payer transfers, ensuring authorization are updated and aligned with the new payer requirements
  • Verify coverage details and authorization rules during payer change to maintain uninterrupted services
  • Manage expired authorization report, identify discrepancies and take corrective action
  • Track and resolve authorization issues that may effect billing, scheduling , or services
  • Communicate with branches regarding or pending authoriztion and require next step
  • Providing guidance and support related to authorization, documents and intake process
  • Respond to branch inquiries promptly and collaborate to resolve authorization or documents issues
  • Communication clearly and professionally via email and internal systems keep all parties informed
  • Ensure all process comply with payor guidelines, company policies and regulatory standards
  • Identify errors or discrepancies and take corrective action to maintain data integrity
  • Support workflow efficiency by proactively addressing issues before they impact patient care or operations

Requirements:

  • High school diploma or GED equivalent, some college preferred
  • 1-2 years of recent experience working in a health care setting and insurance authorizations
  • Excellent written and oral communication skills
  • Excellent customer service skills
  • Must be computer literate and possesses knowledge of computer software, Microsoft Excel (advance skills preferred), internet, Word and Outlook
  • Dependable, conscientious and reliable
  • Ability to analyze and interpret situations to complete tasks or duties assigned
What we offer:
  • Medical, Dental and Vision Benefits
  • Continued Education
  • PTO Plan
  • Retirement Planning
  • Life Insurance
  • Employee discounts

Additional Information:

Job Posted:
February 13, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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