Job Summary:
The Verification Specialist is responsible for ensuring complete, accurate, and timely verification of patient insurance benefits across private and hospital clinics. This role manages pre-certification and pre-authorization for outpatient therapy services, supports clinic staff in understanding patient coverage, and helps secure proper reimbursement for services provided.
Key Responsibilities:
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Verify patient insurance coverage, limits, and benefits.
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Pre-certify and pre-authorize outpatient therapy services.
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Maintain accurate benefit tracking forms and documentation.
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Collect treatment notes and reports for insurance approvals.
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Support patient registration and check-in processes when needed.
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Prepare and submit daily productivity reports.
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Contribute to policy and procedure updates for benefits verification.
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Stay informed on Medicare, Medicaid, and commercial insurance program changes.
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Communicate effectively with patients, insurance companies, and clinic staff.
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Provide telephonic support for authorizations, denials, and appeals.
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Develop proficiency in ICD-10 and CPT coding.
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Assist with end-of-month billing corrections with hospital partners.
Required Skills & Abilities:
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Typing speed of 60 WPM preferred.
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Strong interpersonal, telephone, and written communication skills.
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Excellent organizational and prioritization skills.
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Knowledge of medical terminology, reimbursement, and outpatient billing.
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Ability to work with disabled individuals.
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Familiarity with standard office equipment.
Culture & Development:
PT Solutions builds a strong community focused on expanding access to quality care. Team members benefit from industry-leading clinical education, mentorship opportunities, and an APTA-accredited Orthopaedic Residency Program. This position provides a chance to contribute to advancing rehabilitation services and patient outcomes.