Authorizations Coordinator Jobs (NOW HIRING)

Job Title: Authorizations Coordinator

Location: In Office-West Hempstead, New York
Job Type: Full-Time
Department: Operations
Reports To: Director of Operations

Salary- $65,000/Hourly- $31.25

Schedule: Monday through Friday 830am to 5pm

Position Summary

The Authorizations Coordinator is responsible for managing all payer authorizations to ensure uninterrupted services for clients receiving non-medical home care. This position monitors authorization utilization, expiration dates, and recertification requirements while coordinating with care coordinators, nurses, managed care organizations, Area Agencies on Aging, and internal staff to obtain timely authorization renewals. The Authorizations Coordinator plays a critical role in preventing lapses in service, maintaining regulatory compliance, and supporting accurate billing.

Essential Duties and Responsibilities

• Maintain and oversee all active client authorizations across Medicaid Managed Care, PASSPORT, MyCare Ohio, Ohio Home Care Waiver, and Private Pay.
• Monitor authorization start dates, end dates, approved service hours, units, frequencies, and payer-specific limitations.
• Maintain an authorization tracking system to proactively identify upcoming authorization expiration.
• Review authorization reports daily to identify clients requiring renewal or follow-up.
• Coordinate with nurses, care coordinators, intake staff, and payer case managers to ensure all documentation required for authorization renewals is completed before expiration.
• Schedule nursing reassessments, supervisory visits, and recertification visits according to payer requirements and agency timelines.
• Coordinate and schedule recertification assessments sufficiently in advance to prevent authorization gaps.
• Track physician orders, service plans, assessments, and supporting documentation required for continued authorization approval.
• Submit authorization requests, extensions, and renewals through payer portals or designated submission processes.
• Follow up regularly with managed care organizations, Area Agencies on Aging, and waiver administrators regarding pending authorizations.
• Immediately notify management of authorization delays that may impact client services or agency reimbursement.
• Communicate approved authorization changes to scheduling, billing, and care coordination staff.
• Update the electronic medical record with all authorization information, including approved dates, units, service frequencies, and payer documentation.
• Ensure scheduled caregiver visits remain within authorized service limits.
• Work closely with scheduling to prevent overutilization or underutilization of authorized hours.
• Assist billing by resolving authorization discrepancies prior to claim submission.
• Maintain documentation of all authorization communications and payer correspondence.
• Generate routine reports regarding upcoming authorization expirations, pending renewals, utilization trends, and authorization compliance.
• Participate in quality assurance initiatives related to authorization management and regulatory compliance.
• Maintain confidentiality in accordance with HIPAA and agency policies.
• Perform additional duties as assigned.

Knowledge, Skills, and Abilities

• Thorough understanding of Medicaid authorization processes preferred.
• Knowledge of Ohio PASSPORT, Medicaid Managed Care, MyCare Ohio, Ohio Home Care Waiver, and non-medical home care operations preferred.
• Strong organizational skills with exceptional attention to detail.
• Ability to manage multiple deadlines simultaneously.
• Excellent verbal and written communication skills.
• Strong customer service skills when communicating with clients, payers, and referral sources.
• Ability to prioritize work independently in a fast-paced environment.
• Proficiency in Microsoft Office, particularly Excel.
• Experience using electronic medical record systems, preferably KanTime.
• Ability to analyze authorization utilization and identify potential service interruptions.

Qualifications

• High school diploma or GED required.
• Associate's or Bachelor's degree in healthcare administration, business, or related field preferred.
• At least one year of experience managing insurance authorizations, prior authorizations, or Medicaid waiver services preferred.
• Experience in home care, home health, hospice, or waiver programs strongly preferred.

Performance Expectations

The Authorizations Coordinator is expected to:

• Maintain 100% of active client authorizations without preventable service interruptions.
• Schedule recertification assessments at least 10 days prior to authorization expiration, depending on payer requirements.
• Ensure all renewal documentation is submitted before authorization expiration.
• Maintain accurate authorization records within the EMR.
• Communicate authorization updates promptly to scheduling, billing, clinical, and operations staff.
• Assist the agency in maintaining compliance with Ohio Department of Aging, Ohio Department of Medicaid, managed care organization requirements, and payer regulations.
• Support uninterrupted client care while maximizing reimbursement and minimizing authorization denials.

This role is ideal for an organized healthcare professional who excels at tracking deadlines, coordinating across departments, and ensuring continuous client services through proactive authorization management.