Therapy Authorization and Insurance Verificat

4 weeks ago

Mansfield, United States University Orthopedics Full time
Job DescriptionJob Description

Therapy Authorization & Insurance Verification Specialist

Full Time

Job Title: Therapy Authorization & Insurance Verification Specialist

Reports To: Therapy Billing Manager

GENERAL SUMMARY OF DUTIES:

Our growing Therapy Department is searching for an authorization and insurance verification specialist, responsible for verifying insurance benefits and obtaining authorization required for therapy visits. This position offers flexible hours Monday – Friday between 7:00am – 5:00pm

Essential Job Functions:

  • Communicate with insurance companies to verify patients’ therapy benefits.
  • Verify and obtain Workers’ Compensation state designation and authorization for therapy.
  • Regularly review and keep up to date with current insurance guidelines.
  • Obtain PCP referrals and authorization when required, as per insurance guidelines.
  • Follow up on PCP referrals and Workers’ Compensation requests for therapy visits.
  • Identify and solve complex insurance benefit issues.
  • Follow up with insurance companies to ensure authorization is properly obtained.
  • Assist with billing needs as indicated.
  • Scan and enter authorizations into two EMR systems correctly and accurately.
  • Schedule visits for therapy patient as necessary.
  • Additional duties as assigned by the Manager to meet the department’s needs.

Requirements:

  • High School diploma or equivalent.
  • Interpersonal skills to deal effectively with staff, patients, and physicians.
  • Computer experience and accuracy in data entry regarding patient appointments and scheduling, attention to detail.
  • Ability to multi-task in a fast-paced environment and organizational skills.
  • Ability to work in a high-volume patient-based clinic.
  • Knowledge of third-party billing.
  • Medical experience and knowledge of medical terminology.
  • Ability to maintain confidentiality.
  • Must be flexible with work hours.
  • Must be able to travel to all sites if/when necessary.

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