Therapy Managed Care Coordinator

Therapy Managed Care Coordinator

Be the vital connection between quality care and patient access.

Elderwood is seeking a detail-driven Therapy Managed Care Coordinator to join our Rehabilitation Services team. In this role, you'll support our Directors of Rehab while serving as the key liaison between our skilled nursing facilities and managed care organizations. Your work ensures patients receive timely, authorized therapy services and that our teams can focus on delivering exceptional care.

Why Join Elderwood?

• Be part of a mission-driven healthcare organization rooted in compassion and excellence.
• Work closely with therapy and rehab leaders to make an impact on patient access and outcomes.
• Grow your career in a supportive, collaborative corporate environment.
• Flexible hybrid schedule: work from home with on-site visits to facilities and EAS (corporate office).

What You'll Do

• Coordinate and process prior authorizations and re-authorizations for physical, occupational, and speech therapy services.
• Submit requests, track statuses, and follow up with insurance companies to secure timely approvals.
• Collect and organize documentation (evaluations, progress notes, recertifications) to support authorization requests.
• Communicate updates, approvals, and denials to facility leadership, rehab directors, and billing staff.
• Assist with peer-to-peer requests, claim denials, appeals, and external audits.
• Maintain accurate records of all communications while upholding compliance, HIPAA, and Elderwood's values.

Elderwood Values

• At Elderwood, we live by Integrity, Collaboration, Accountability, Respect, and Excellence. As a Therapy Managed Care Coordinator, you'll play a central role in ensuring these values extend into every patient interaction and administrative process.

Ready to make an impact? Apply today to join a team where your skills in organization, communication, and managed care coordination directly contribute to patient well-being and our mission of excellence in long-term care.

Responsibilities

Therapy Managed Care Coordinator:

• Coordinate and process prior authorizations and re-authorization requests for therapy services, including physical, occupational, and speech therapy.
• Submit requests for authorization, monitor status, and follow up with insurance companies to obtain approvals in a timely manner.
• Collect documents to support the prior authorization request, for example, evaluations, progress notes, daily notes, recertification.
• Assist the DOR in tracking authorization renewals to prevent service interruptions
• Maintain detailed and organized records of all communication and authorization activities, including but not limited to, call reference numbers, fax confirmations, and PDF printouts of authorization requests.
• Communicate authorization updates and requirements to the Rehab Director and billing department at the facility level.
• Communicate denials of services immediately to help coordinate a peer-to-peer discussions when appropriate.
• Assist with gathering documents for claim denials to prepare for the appeal process.
• Assist with gathering documents for external audits.
• Maintain privacy and compliance with policies and procedures within a secure environment of documentation and communication.
• Utilizes electronic timekeeping system as directed.
• Arrives to work on time, regularly, and works as scheduled.
• Recognizes and follows the dress code of the facility including wearing name tag at all times.
• Follows policy and procedure regarding all electronic devices, computers, tablets, etc.
• Supports and abides by Elderwood's Mission, Vision, and Values.
• Abides by Elderwood's businesses code of conduct, compliance and HIPAA policies.
• Performs other duties as assigned by supervisor, management staff or Administrator.
• Stay current with payer policies, authorization requirements, and regulatory updates impacting therapy services.
• Support the rehab department in meeting compliance standards and optimizing reimbursement

Qualifications

Therapy Managed Care Coordinator:

• Minimum of High School Diploma
• 1 2 years of experience within the HMO Managed Care Insurance Companies
• Knowledge of Medicare and Medicaid Managed Care Policies and Utilization Review.

EOE Statement

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.