Medicaid Eligibility/Authorization Coordinator Sunshine Homecare Services

Position: Medicaid Eligibility / Authorization Coordinator Reports To: Controller Position Summary: At Sunshine Homecare Services, we believe access to quality care begins with compassion, accuracy, and advocacy.

We are seeking a dedicated Medicaid Eligibility / Authorization Coordinator who is passionate about supporting patients and families by ensuring uninterrupted insurance coverage and timely authorizations.

This role is vital to our mission, serving as a key liaison between patients, families, payers, and internal teams.

The Coordinator ensures that eligibility, authorizations, and compliance requirements are met so our clients can receive care without delay across all Sunshine Homecare agencies.

Qualification: Bachelor's Degree with 35 years of experience in Medicaid eligibility and authorization management within a healthcare setting, including acquiring and maintaining authorizations for Medicaid and other insurance plans.

Knowledge of NHTD and TBI program requirements and regulations is a plus.

Experience working directly with patients, family members, service coordinators, Medicaid representatives, and insurance companies.

Ability to read, write, and comprehend instructions, short correspondence, and memos; ability to draft professional written communications.

Strong verbal communication skills, with the ability to effectively present information in one-on-one and small-group settings.

Proficiency in office equipment and computer applications, including Microsoft Word and Excel.

Strong organizational, interpersonal, and time-management skills.

Ability to apply common-sense reasoning to carry out instructions and resolve routine issues.

Ability to manage standardized processes with occasional variables in a fast-paced environment.

Contacts: External Contacts: Patients and patient families Service coordinators Medicaid representatives Insurance companies Outside billing vendors Internal Contacts: Administrative staff Intake team Finance department Equipment Used: Computer Telephone Copier Fax machine Specific Duties & Responsibilities (ADA Essential Functions): In compliance with the Americans with Disabilities Act (ADA), essential job functions are identified below.

A duty is considered essential if the position exists to perform that duty, requires specialized skills, or can only be performed by a limited number of employees.

Confirm patient insurance coverage and eligibility for services prior to admission and before services are rendered.

Obtain initial and ongoing authorizations from Medicaid and insurance companies, ensuring all required documentation is submitted accurately and timely.

Serve as a liaison between patients, families, insurance representatives, service coordinators, and clinical staff to facilitate the authorization process and resolve issues.

Gather and submit all required documentation for patients enrolled inNHTD and TBI programs.

Track patient eligibility status and ensure continuous enrollment to prevent ser...