Pre-auth Specialist

We are a licensed home care agency in New York specializing in private duty nursing. We work with multiple managed care organizations and insurance payers, and timely, accurate pre-authorizations are critical to keeping our patients staffed and our revenue cycle healthy. We're looking for a detail-oriented Pre-Authorization Specialist to own the authorization process from submission through approval. You'll be responsible for submitting prior authorization requests, tracking authorized hours and units, and following up persistently with payers until every authorization is secured and current. This role requires someone who is comfortable with numbers, organized, and communicates clearly with both insurance representatives and our internal team. Responsibilities Submit prior authorization and re-authorization requests to insurance payers and MCOs Track authorization periods, authorized hours/units, and utilization to prevent lapses in coverage Accurately calculate authorized units, remaining balances, and utilization against scheduled hours Follow up consistently and proactively with payers on pending authorizations — no request falls through the cracks Document all authorization activity clearly and keep internal records up to date Communicate authorization status, issues, and deadlines to the scheduling and billing teams promptly Escalate denials or delays and assist with resolution