Insurance Authorization and Verification Specialist

Job Description

Summary:

Very independent and self-directed position. Contacts multiple insurance companies to determine individual physical therapy benefits according to patient specific plan. Works with multiple providers regarding patient plan of care. Communicates to insurance companies regarding date range, plans of care, past and future care for patients, in order to obtain authorization for appropriate care. Requires organization, persistence and excellent follow through.

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Requirements:

· Must adhere to strict confidentiality and HIPAA requirements

· Must be able to type 40wpm minimum

· Ability to multitask

· Must be accurate and efficient

· Detail Oriented

· Thorough

· Flexible and Adaptable

· Ability to work with little supervision

· Dependable

· Professional demeanor, speech and tone

· Accurate in basic data entry

· Excellent math skills

· Professional phone etiquette and communication

· Must be able to follow through on tasks to completion regardless of obstacles

· Team Player

· Ability to navigate insurance websites

· Ability to learn new software programs

· Ability to work accurately in a fast paced environment

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Duties:

· Uses in house forms to verify patient coverage and benefits for physical therapy.

· Communicates effectively with Receptionists regarding coverage, explains benefits to patients

· Detects any complications in coverage that would affect payment for service and resolves the complication prior to the patient’s first visit.

· Uses EMR software to track patient visits and determine when an authorization request must be completed and submitted in order for the patient to continue, without interruption, in their plan of care.

· Anticipates questions or problems an insurance may have with a request for additional visits, resolves any obstacles to continued and appropriate care.

· Understands permissible and non-permissible requests.

· Adjusts rapidly to changes in insurance prior authorization requirements.

· Communicates changes, updates and new information with providers.

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Job Types: Full-time, Part-time

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Pay: From $16.00 per hour