Insurance Verification & Authorization Specialist – Physical Therapy, Orthopedic

Job Description

We are seeking a dedicated Insurance Verification & Authorization Specialist to ensure accurate and timely processing of insurance claims for our healthcare clients. In this role, you will: * Contact insurance providers to verify coverage, benefits, and requirements. * Perform phone verification for all first-time patient visits, going beyond portal-only verification. * Thoroughly document all verification details, including representative name and reference number. * Adhere to required verification procedures consistently. * Initiate, submit, and meticulously follow up on prior authorization requests. * Track authorization status diligently and ensure timely updates. * Maintain accurate documentation of approvals and pending requests. * Follow established verification workflows and protocols. * Retrieve missing or incomplete information from patient charts as needed. * Keep tracking spreadsheets updated for verifications and authorizations.

Qualifications

To be successful in this role, you should have: 1. At least 2 years of direct experience handling Benefits & Eligibility verification for U.S. healthcare providers. 2. Strong experience in insurance verification and prior authorizations, preferably in PT/OT/Speech Therapy. 3. Excellent attention to detail and a commitment to following specific protocols. 4. Comfort and proficiency in making frequent insurance calls. 5. Proficiency in Google Sheets or Excel. 6. Experience in medical billing or revenue cycle management. 7. A background in Physical Therapy or Orthopedics. 8. Familiarity with Prompt (EMR). 9. Proficiency in speaking and writing English clearly. 10. Relevant work experience. 11. Ability to submit an NBI clearance and/or Local Police Clearance background check before onboarding. 12. Availability for video meetings with your camera on when needed. 13. Reliable laptop or desktop computer. 14. High-speed internet connection (minimum 10 Mbps). 15. Noise-canceling headset. 16. Webcam for virtual meetings. 17. Quiet, professional workspace.

Benefits

As a member of our team, you'll receive: - Dedicated HR & Contractor Support Team: Assistance for questions, guidance, contract matters, and client communication. - Premium VPN Access (Optional): A secure VPN license to enhance privacy and security. - HIPAA & Cybersecurity Training + Certification: Training and certification to confidently handle PHI for U.S. healthcare clients. - Top 1% VA Performance Training: Proprietary training on communication, client management, and productivity. - Client-Approved U.S. Holidays: Time off according to the client’s needs. - Client-Approved Paid or Unpaid Time Off: Time off granted by the client; paid time off is optional. - Access to Tools & Resources: Templates, workflow guides, productivity tools, and client-specific SOP support. - Optional Performance-Based Incentives: Potential bonuses, incentives, or increased hours.