Verification Specialist

Position Summary:Ensures complete, accurate, and timely verification of insurance benefits for patient registrations (both private clinic and hospital clinic); assists clinic staff with completion of insurance benefit verification for all patient evaluations and re-evaluations. This position is also responsible to pre-certify/pre-authorize outpatient therapy services.Essential Functions:• Obtains necessary information to initiate the insurance verification process.• Contacts insurance companies to verify coverage, limits, etc. as directed by policy.• Initiates tracking forms for outpatients based on patient benefits available.• Obtains reports and treatment notes when needed for insurance authorization and payment.• Assists with outpatient registrations and/or check-ins when needed.• Prepares daily productivity report and submits it to the business office manager.• Assists in the preparation of policies and procedures manuals for benefits verification.• Expands knowledge of insurance benefits and program changes related to Medicare, Medicaid, and commercial carriers by reviewing literature, attending seminars, and taking advantage of continuing education opportunities.• Communicate and cooperate with clinic personnel.• Obtain patient, billing and insurance information in order to maintain current and accurate information in patient files and billing system.• Coordinate with clinic personnel as is necessary to ensure their understanding of patients’ insurance benefits and to secure appropriate reimbursement for services rendered.• Perform telephonic support for online authorization of therapy services• Provide direct support to clinic personnel regarding utilization, authorization, and referral activities• Become proficient in the use of ICD-10 and CPT codes• Contact clinics with authorization, denial, and appeals process information• Performs additional duties deemed necessary to the position and its function.• Assist with end of month corrections on the back end with hospital partners.

Required Skills & Abilities:• Ability to type 60 words per minute preferred.• Strong interpersonal, oral (includes telephone skills) and written communication skills.• Good organizational skills and an ability to prioritize to meet deadlines.• Complete understanding of medical reimbursement and terminology.• Ability to work with disabled individuals.• Working knowledge of all standard office equipment.• Working Knowledge of insurance and outpatient billing procedures.  

Expanding Access to Quality Care

At PT Solutions, we’re more than colleagues; we’re a tight-knit community united in our mission to expand access to quality care. Our commitment to you is evident in our industry-leading professional development opportunities. From ongoing evidence-based clinical education to dedicated mentorship opportunities and an APTA-accredited Orthopaedic Residency Program, we propel our clinicians toward excellence in physical therapy, occupational therapy, speech-language pathology, and athletic training.

As we aim to be the go-to rehabilitation provider, we seek committed professionals eager to join us in that mission. A career with PT Solutions is an opportunity to shape the industry and make a lasting impact. 

Let’s go further together and transform care. Join the #PTSLife today! 

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