Authorization Manager

Elite Home Health Care is a licensed home care agency that provides professional homecare services in the New York Metropolitan area, Central, and Upstate NY Regions. At Elite, we only hire the most qualified nurses, home health aides and caregivers who are hand-picked based on their skills and capabilities. They are all licensed, insured and cleared with extensive background screening. But most importantly, our caregivers are known for their warmth, attentiveness and reliability.

Our main goal is to deliver compassionate, professional, and integrity-centered care to our clients. We work within the community to provide quality home care for individuals in need. We are committed to providing our clients with the best possible and most compassionate care!

Owns the authorization function end to end and the pre-billing function end to end, along with all reporting mechanisms on both. Manages the authorization coordinator team, works directly with branch managers to review authorized visits, owns over utilization, and oversees temporary authorizations with support from the Authorization Specialist. This role protects revenue integrity — the gap between what is authorized and what is scheduled is this role’s to close.

• Owns the full authorization lifecycle across all payors: new authorizations, reauthorizations, increases, decreases, extensions, retroactive authorizations
• Manages the Authorization Coordinator team and their payor portfolios; ensures full cross-coverage during absences
• Owns authorization tracking, expiration monitoring, and daily payer follow-up as a managed process, not an individual task
• Escalates high-risk cases: imminent expirations, high-hour patients, pediatric and fragile patients, cases at risk of discharge
• Maintains current working knowledge of payor rules — auth duration, units, renewal timelines, required documentation — across the full payor set

• Owns the weekly pre-billing authorization review ahead of every billing run
• Compares authorized hours to scheduled hours; identifies and resolves anything that would block claims submission (expired auths, missing units, wrong auth type, wrong dates)
• Owns resolution of billing discrepancies in partnership with Billing
• Accountable for zero billing holds caused by missing or incorrect authorizations

• Owns identification and resolution of over utilization — where delivered or scheduled hours exceed authorized units
• Processes and oversees ad-hoc T-auth updates when services exceed authorization
• Reports over utilization patterns by payor and by branch to the Director

• Works directly with branch managers to review all authorized visits
• Serves as the authorization-side counterpart to Operations on staffing and scheduling decisions
• Flags to branches where scheduling is running ahead of authorization

• Oversees the temporary authorization process, executed day to day with support from the Authorization Specialist
• Ensures temp auths are converted to permanent authorizations and not left open

• Owns all reporting mechanisms on authorization and pre-billing: volumes, turnaround times, expirations, over utilization, billing holds, discrepancy resolution
• Delivers regular reporting to the Director and to leadership

• Zero expired home care authorizations
• Zero billing holds due to missing or incorrect authorizations
• Over utilization identified and resolved before billing run
• Pre-billing review completed ahead of every billing cycle

• Supervisory or management experience in a home care, LHCSA, or managed care authorization/billing…