Description
Authorization and Intake Specialist - LPN
Partners In Home Care (PIHC), is seeking a detail-oriented Authorization and Intake Specialist to support timely, compliant, and accurate admissions across all clinical programs.
Why You’ll Love Working With Us
- Flexible scheduling and generous paid time off to support work-life balance!
- Comprehensive benefits including Medical, Dental, Vision, and Supplemental Insurance -Beginning the first of the month following your start date. No months of waiting!
- 401(k) with company match up to 5%
- Company-paid life insurance
- Tuition reimbursement and annual training budget
- Employee Assistance Program (EAP)
- Additional perks including legal services, ID protection, pet insurance, and financial wellness programs
- Deliver care where it matters most—at home
- Enjoy professional autonomy with the support of a collaborative interdisciplinary team
Employment Type: Full-Time/On-Site
Schedule: Monday-Friday
Location: Missoula, MT
The Authorization and Intake Specialist (LPN) is responsible for coordinating patient referrals, verifying eligibility, securing payer authorizations, and ensuring regulatory compliance for Home Health and Hospice admissions. This role includes clinical review of Face-to-Face (F2F) documentation to confirm it meets Medicare and payer requirements prior to admission. The position serves as a key liaison between referral sources, clinical teams, physicians, and payers to ensure timely, compliant, and accurate patient onboarding.
Key Responsibilities
Intake & Referral Coordination
- Receive, process, and track incoming Home Health and Hospice referrals
- Verify patient demographics, insurance coverage, and payer criteria
- Communicate with hospitals, clinics, and community referral sources
- Ensure referral documentation is complete and accurate before admission
- Enter and maintain referral information in the EMR
Insurance Verification & Authorization
- Confirm benefits, eligibility, and coverage limits
- Obtain prior authorizations for services, visits, and DME
- Track authorization timelines and visit utilization
- Communicate authorization updates to clinical and scheduling teams
LPN Clinical Review & Face-to-Face Documentation
- Review referrals for clinical appropriateness and eligibility
- Identify missing or incomplete documentation and coordinate follow-up
- Perform F2F documentation review to ensure:
- Provider signature/date
- Required timeframes met
- Homebound status (HH) or terminal prognosis (Hospice) clearly supported
- Medical necessity is documented
- Coordinate with providers to correct non-compliant F2F notes
- Monitor outstanding F2Fs to avoid delays or billing risk
Care Coordination & Compliance
- Communicate admission readiness to clinical managers
- Coordinate start-of-care timing with field clinicians
- Support compliance with Medicare/Medicaid, accreditation standards, and HIPAA
- Participate in audits, quality reviews, and process improvement efforts
Requirements
Required Qualifications
- Active Licensed Practical Nurse (LPN) license in the state of employment
- Minimum 2 years clinical experience (Home Health, Hospice, hospital, or case management preferred)
- Knowledge of Medicare, Home Health and Hospice eligibility criteria
- Experience with insurance verification and prior authorization processes
- Strong understanding of medical terminology and clinical documentation
Preferred Qualifications
- Prior intake or authorization experience in Home Health or Hospice
- Experience reviewing Face-to-Face encounter documentation
- Familiarity with EMR systems used in post-acute care
- Knowledge of PDGM (Home Health) and Hospice Conditions of Participation
Summary
Partners In Home Care is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.