Aveanna Healthcare
TPL Specialist
This is a temporary remote position. Starting as soon as possible. The position will end between February and April 2026 (could be extended). Join a Company That Puts People Firstand Wins Awards Doing It! At Aveanna, we're proud to create a workplace where you feel valued, supported, and inspired. Here's what sets us apart: Award-Winning Workplace Recognized for Best Leadership, Best Diversity, Best Company for Women, Best Career Growth, Work-Life Balance, Happiness, and Top-Rated Outlook in 2025. Proud partner of the Military Spouse Employment Partnership. Connection & Support Employee Connection Groups: Spaces to share experiences and build community. Social Circles: Connect over shared interestsbooks, music, movies, and more. At Aveanna, your well-being matters. That's why on Wellness Wednesday's, we give you tools to recharge, reset and refocus. Inclusive Growth Open learning sessions for all employeesbecause we grow stronger together. Aveanna Cares
Service with Heart Every year, we embrace our Month of Service, giving you the chance to volunteer in your local community with your team. It's a powerful way to give back, connect, and live our values beyond the workplace. Real Help When You Need It Most Through the Aveanna Employee Relief Fund, we stand by each other during life's toughest momentsoffering financial assistance to teammates facing unexpected hardships. Because here, care goes beyond the job description. Position Overview The primary responsibility of the TPL Specialist is to assist with quality assurance and accuracy of claims review and support of the third party liability (TPL) processes. Essential Job Functions Review and maintain accurate and updated patient information in billing system Conducts direct contact with patient's health insurance company to verify eligibility Conducts direct contact with patient's health insurance company to verify services are covered under patients benefit plan Initiates authorization process with the health insurance plan Communicates required documentation needed to complete the authorization process Timely and consistent follow up with locations for requested information Confirms any secondary policies and applies same process regarding eligibility, benefits and authorization requirements Forecasts and communicates potential Billing and A/R challenges or concerns to the Billing and A/R managers Conducts an accurate review of received documents to determine specific requirements are met for compliance Calculates benefits based on each individual policy or plan with strong attention to detail and accuracy Attention to detailed information related to Home and Local plans as well as HMO and PPO policies CMO's and government payers Attention to detailed information related to Home and Local plans as well as HMO and PPO policies Requirements High school diploma or GED Proven ability to analyze complex process errors and identify root cause corrections. Preferences Healthcare and insurance payer knowledge/experience is preferred. Professional coding certifications strongly preferred. Other Skills/Abilities Must be able to adhere to confidentiality standards and professional boundaries at all times Attention to detail Time Management Ability to remain calm and professional in stressful situations Strong commitment to excellence Quick-thinking and astute decision making skills Effective problem-solving and conflict resolution Excellent organization and communication skills Waystar, excel and computer skill proficiency Physical Requirements Must be able to speak, write, read and understand English Occasional lifting, carrying, pushing and pulling of 25 pounds Prolonged walking, sitting, standing, bending, kneeling, reaching, twisting Must be able to sit and climb stairs Must have visual and hearing acuity Must have strong sense of smell and touch Environment Performs duties in an office environment during agency operating hours Must be able to function in a wide variety of environments which may involve exposure to allergens and other various conditions Needs to mention a split of in home and in the office requirements Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Headhunters and recruitment agencies may not submit resumes/CVs through this website or directly to managers. Aveanna does not accept unsolicited headhunter and agency resumes, and will not pay fees to any third-party agency or company that does not have a signed agreement with Aveanna. CCPA Notice for Job Applicants, Contractors, and Employees Residing in California
This is a temporary remote position. Starting as soon as possible. The position will end between February and April 2026 (could be extended). Join a Company That Puts People Firstand Wins Awards Doing It! At Aveanna, we're proud to create a workplace where you feel valued, supported, and inspired. Here's what sets us apart: Award-Winning Workplace Recognized for Best Leadership, Best Diversity, Best Company for Women, Best Career Growth, Work-Life Balance, Happiness, and Top-Rated Outlook in 2025. Proud partner of the Military Spouse Employment Partnership. Connection & Support Employee Connection Groups: Spaces to share experiences and build community. Social Circles: Connect over shared interestsbooks, music, movies, and more. At Aveanna, your well-being matters. That's why on Wellness Wednesday's, we give you tools to recharge, reset and refocus. Inclusive Growth Open learning sessions for all employeesbecause we grow stronger together. Aveanna Cares
Service with Heart Every year, we embrace our Month of Service, giving you the chance to volunteer in your local community with your team. It's a powerful way to give back, connect, and live our values beyond the workplace. Real Help When You Need It Most Through the Aveanna Employee Relief Fund, we stand by each other during life's toughest momentsoffering financial assistance to teammates facing unexpected hardships. Because here, care goes beyond the job description. Position Overview The primary responsibility of the TPL Specialist is to assist with quality assurance and accuracy of claims review and support of the third party liability (TPL) processes. Essential Job Functions Review and maintain accurate and updated patient information in billing system Conducts direct contact with patient's health insurance company to verify eligibility Conducts direct contact with patient's health insurance company to verify services are covered under patients benefit plan Initiates authorization process with the health insurance plan Communicates required documentation needed to complete the authorization process Timely and consistent follow up with locations for requested information Confirms any secondary policies and applies same process regarding eligibility, benefits and authorization requirements Forecasts and communicates potential Billing and A/R challenges or concerns to the Billing and A/R managers Conducts an accurate review of received documents to determine specific requirements are met for compliance Calculates benefits based on each individual policy or plan with strong attention to detail and accuracy Attention to detailed information related to Home and Local plans as well as HMO and PPO policies CMO's and government payers Attention to detailed information related to Home and Local plans as well as HMO and PPO policies Requirements High school diploma or GED Proven ability to analyze complex process errors and identify root cause corrections. Preferences Healthcare and insurance payer knowledge/experience is preferred. Professional coding certifications strongly preferred. Other Skills/Abilities Must be able to adhere to confidentiality standards and professional boundaries at all times Attention to detail Time Management Ability to remain calm and professional in stressful situations Strong commitment to excellence Quick-thinking and astute decision making skills Effective problem-solving and conflict resolution Excellent organization and communication skills Waystar, excel and computer skill proficiency Physical Requirements Must be able to speak, write, read and understand English Occasional lifting, carrying, pushing and pulling of 25 pounds Prolonged walking, sitting, standing, bending, kneeling, reaching, twisting Must be able to sit and climb stairs Must have visual and hearing acuity Must have strong sense of smell and touch Environment Performs duties in an office environment during agency operating hours Must be able to function in a wide variety of environments which may involve exposure to allergens and other various conditions Needs to mention a split of in home and in the office requirements Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Headhunters and recruitment agencies may not submit resumes/CVs through this website or directly to managers. Aveanna does not accept unsolicited headhunter and agency resumes, and will not pay fees to any third-party agency or company that does not have a signed agreement with Aveanna. CCPA Notice for Job Applicants, Contractors, and Employees Residing in California