• Investigate, evaluate, negotiate and adjust moderate to high complexity claims presented by or against our insureds • Confirm coverage, determine legal liability and equitably settle/defend in compliance with all state regulatory requirements • Manage and support the customer through the damages process for both repairable and total loss claims • Look for recovery opportunities and pursue them when appropriate • Provide claims service via various channels to policy holders and third-party customers • Acquire and apply advanced knowledge of Property & Casualty insurance industry products, services, and processes • Seek guidance from team members to resolve issues and identify appropriate issues for escalation • Partner with and/or directs vendors and internal business partners to facilitate claims resolution • Contribute to business goals, performance metrics, and effectively use tools & technology • Support workload surges and/or catastrophe operations as needed

Join VitalCaring – Where Your Passion Changes Lives! Are you looking for a career where compassion meets purpose? At VitalCaring, we’re more than a home health and hospice provider—we’re a family that supports, inspires, and uplifts both our patients and our team members. Who We Are Founded in 2021, VitalCaring has grown into a leading provider of home health and hospice services, with over 65 locations across the country. We are committed to fostering a culture of support, growth, and excellence for our team that is the backbone of how we ensure we deliver exceptional patient care. Why Choose VitalCaring? Work That Fits Your Life – Discover the ideal balance of purpose and flexibility. As a full-time salaried clinician, you’ll enjoy the stability of a consistent role with the freedom to manage personal commitments throughout your day. Our field team thrives in an environment that empowers them to make a real impact—while still having the time and space to prioritize what matters most at home. With a generous 6 weeks of paid time off each year, you’ll have the opportunity to recharge, reconnect, and return ready to do your best work. Make a Meaningful Impact – Help patients and families navigate their healthcare journey with compassion and dignity. Thrive in a Supportive Team – Work with a team who genuinely care and invest in your success. Grow Your Career – Take advantage of advanced training, mentorship, and career development opportunities. Competitive Pay & Benefits – Receive a rewarding compensation package that recognizes your dedication and expertise. Our benefits are designed to empower you with the resources, flexibility, and security needed to thrive both professionally and personally. This is a remote position eligible to those who reside in Alabama, Mississippi, Texas, Louisiana, Oklahoma, or Florida Health & Wellness Medical, Dental & Vision Pharmacy Benefits Virtual & Mental Health Support Flexible Spending Accounts (FSAs) & Health Savings Account (HSA) Supplemental Health & Life Insurance Financial & Legal 401(k) with Company Match Employee Referral Program Prepaid Legal Plans Identity Theft Protection Work-Life Balance & Perks Paid Time Off Pet Insurance Tuition & Continuing Education Reimbursement As the Insurance Verification and Authorization Specialist, you will: - Conduct insurance verification through payer portals, phone calls, and HCHB’s integrated tools for all new referrals and ongoing patients. - Initiate and obtain prior authorizations for home health services including nursing, therapy, and aide services as required by payers. - Accurately enter and maintain insurance, authorization, and eligibility information within the HCHB system in real-time. - Review patient intake information to ensure payer requirements are identified and addressed early in the admission process. - Collaborate with intake, clinical staff, case managers, and billing teams to resolve authorization-related issues promptly - Follow up proactively with insurance companies to ensure timely processing of authorizations and appeals. - Stay current on payer-specific authorization protocols, documentation requirements, and changes to coverage policies affecting home health. - Ensure compliance with HIPAA, Medicare Conditions of Participation, and other regulatory standards. - Maintain organized and auditable records of all insurance and authorization communications and decisions within HCHB and agency systems Skills for Success: - Fully remote during agency operating hours - Ideal candidate should reside in Texas, Louisiana, Mississippi, Florida, or Alabama - Regular use of computers, phones, and HCHB software system. - Requires flexibility and the ability to adapt to frequent changes in payer rules and agency workflows. - Work deals mostly with areas such as preparing and reading data and figures, records, reports, visual inspection involving small details. Although important, depth perception and field of vision (peripheral) are not as critical as the ability to distinguish small details and markings very near to the observer. - Requires ability to concentrate on fine detail with frequent interruption; ability to focus attention on tasks for 10-20 minutes at a time on a continuous basis, 20-60 minutes on occasion. - Requires the ability to remain calm and courteous under stress. - Requires working under strict turnaround time guidelines to meet business needs. - Requires ability to communicate clearly and make self-understood effectively in face-to-face interactions; articulate with accuracy to communicate using phone. - Requires ability to hear and receive verbal instructions correctly, answer phones, communicate professionally in situations with some background noise. - Requires ability to understand and relate to specific ideas one at a time and to the concepts behind specific ideas; ability to remember verbal and written tasks/assignments from a few hours to several day periods. - Excellent computer software skills necessary to produce accurate documents and materials required. - Working knowledge of MS Office, Excel or similar software required. Proficient knowledge preferred. - Requires ability to work effectively under minimal supervision; exercise excellent, sound professional judgment and maintain confidentiality. - Must have and maintain valid Driver’s License, and proof of current valid auto liability insurance. Experience to Deliver on our Mission: - High school diploma or equivalent required; associate degree or higher preferred. - Minimum 2 years of experience in home health authorization/eligibility processes. - Proficiency in Homecare Homebase (HCHB) strongly preferred. - Strong understanding of traditional Medicare, Medicare Advantage, and commercial insurance guidelines. - Experience navigating payer websites/portals (e.g., Availity, Waystar, Palmetto etc.). - Detail-oriented with excellent organizational and follow-up skills. - Effective communication and customer service skills with both internal teams and external payers. - Ability to multitask in a high-volume, fast-paced remote or office environment. Come home to VitalCaring where you will find your passion, find your people, and find yourself again. Together we can transform lives and foster hope through genuine caring. Explore your future with VitalCaring today.

• Engage with members via phone, email, and other channels to assist with quotes, new policies, billing inquiries, underwriting questions, and policy changes. • Build rapport and trust by asking thoughtful questions, understanding member needs, and offering accurate solutions to minimize transfers and escalations. • Process insurance transactions such as endorsements, cancellations, and coverage updates while ensuring compliance with industry regulations and internal policies. • Collaborate with insurance carriers and internal teams to resolve issues and provide timely, accurate information. • Maintain required certifications and actively pursuing opportunities to grow product knowledge. • Meet performance metrics related to service quality, responsiveness, and member satisfaction.

• Conducts complex risk assessments for insured properties and operations to inform underwriting decisions • Identifies potential risk exposures and formulates strategic recommendations to mitigate identified risks • Interprets and analyzes loss data to identify trends and implements tailored client loss prevention programs • Provides advanced technical guidance and conducts training for clients on safety practices and regulatory compliance • Monitors the effectiveness of loss control measures and makes strategic adjustments to enhance outcomes as needed • Delivers joint marketing presentations in collaboration with underwriting, claims, and sales to accounts and agents • May have responsibility for performance and coaching of staff and may have a participatory role in decisions regarding talent selection, development, and performance management for direct reports • Performs other duties as assigned.