Home Health Prior Authorization & Intake Specialist

About the role

A home health agency serving U.S.-based agencies is hiring an experienced Prior Authorization & Intake Specialist in Model Town, Lahore. The role covers end-to-end patient intake, referral processing, insurance verification and prior authorization, working nights from 7:30 PM to 4:30 AM PKT, six days a week including alternate Saturdays, on site.

Key responsibilities

• Manage referrals, intake processing and patient admissions from receipt through admission.
• Enter patient demographics, referral details, physician orders and clinical documentation into EMR/EHR systems.
• Verify insurance eligibility, benefits and Home Health coverage, including Medicare, Medicaid, Medicare Advantage and commercial plans.
• Determine authorization requirements and submit prior authorization requests, then follow up on approvals, denials, reconsiderations and appeals.
• Work with insurance portals and payer representatives to resolve authorization issues.
• Coordinate with physicians, referral sources, patients and clinical teams for missing documentation and signatures.
• Coordinate Start of Care (SOC), clinician assignments and admission requirements, and track pending authorizations and admission timelines.
• Maintain accurate records of authorization details, approved services, visit limits and validity periods, and escalate delays affecting admissions.
• Ensure compliance with HIPAA and agency documentation standards.

Required profile

• Previous hands-on experience in U.S. Home Health Intake, Admissions and/or Operations is mandatory.
• Experience verifying insurance eligibility, benefits and coverage, and processing prior authorizations.
• Strong written and verbal English, and excellent organization, follow-up, multitasking and problem-solving skills.
• Preferred: handling denials and appeals, coordinating with RN, PT, OT, ST, MSW and HHA disciplines, and supporting multiple U.S. home health agencies.

Required skills

• Insurance platforms: Availity, UHC, Cohere, Carelon, UMR, Palmetto, Waystar.
• EMR/EHR systems: Alora, Kinnser, KanTime.
• Knowledge of Medicare, Medicare Advantage, Medicaid and commercial insurance requirements.

To apply, send an updated CV, salary expectations and notice period, and a 60-90 second voice introduction by email to the recruiter.