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The Care Team · 1 day ago

Eligibility & Pre-Billing Coordinator (34247)

Farmington, MI

Full-time

Onsite

Entry Level

1+ years exp

The Care Team Hospice is seeking an organized and detail-oriented Eligibility & Pre-Billing Coordinator to support hospice and palliative care services. The role involves determining patient eligibility for insurance benefits, coordinating authorizations, and ensuring timely acceptance of clinical data to protect continuity of care and prevent delays in reimbursement.

FitnessHealth CareWellness

Growth Opportunities

Responsibilities

Determine patient eligibility for insurance benefits prior to start of care

Run and review eligibility information through payer portals and update demographics and payor set-up accordingly

Obtain and coordinate pre-certifications and authorizations for commercial, Medicaid, and other authorization-driven payors

Submit required notices including NOA, NOE, and other regulatory payer communications

Validate and submit clinical data such as OASIS and HIS assessments, ensuring timely acceptance

Track denied visits, episodes, and room-and-board eligibility, including managing lock-ins and lock-outs

Maintain accurate logs of denials and authorization activity

Collaborate with clinical teams to update notes with key eligibility details

Reverify eligibility periodically to support ongoing compliance

Run reports and follow Standard Operating Procedures to ensure revenue is collectible

Qualification

Insurance verification processesPayer portalsEMR systemsPre-certificationsAuthorizationsMedicareMedicaid experienceHospice experienceHomecare Homebase familiarityAttention to detailTime-management skillsProblem-solving