Authorization & Insurance Verification Specialist

Peak Performance Physical Therapy, PLC•Lansing, MI

1d•Onsite

About The Position

Peak Performance Physical Therapy is looking for a detail-oriented, dependable, and patient-focused team member to join our Billing Department as a Full-Time Authorization & Insurance Verification Specialist. This role is an important part of the patient experience and overall revenue cycle process. The Authorization & Insurance Verification Specialist helps ensure patients are set up for care with accurate insurance information, timely authorizations, and clear communication between departments. This position supports our clinics, providers, intake team, and billing team by helping reduce delays in care and keeping patient accounts accurate from the start. The Authorization & Insurance Verification Specialist is responsible for verifying patient insurance benefits, obtaining and tracking authorizations, maintaining accurate documentation, and communicating insurance-related information to the appropriate team members. This role requires strong attention to detail, follow-through, organization, and the ability to work collaboratively in a fast-paced healthcare environment.

Requirements

Strong written and verbal communication skills
Ability to maintain accuracy while working in a busy environment

Nice To Haves

Previous experience in healthcare billing, insurance verification, authorizations, credentialing, patient accounts, or front office healthcare support preferred
Familiarity with insurance terminology, benefits, referrals, authorizations, deductibles, copays, coinsurance, visit limits, and payer enrollment processes preferred
Experience with provider credentialing, CAQH maintenance, payer portals, and insurance enrollment systems preferred
Experience with EMR systems, payer portals, fax queues, and Microsoft Office/Excel helpful
Highly organized and detail-oriented
Comfortable working with insurance information, payer portals, credentialing systems, and documentation requirements
Able to manage multiple tasks, deadlines, and follow-up items throughout the day
Strong in follow-through and communication
Comfortable asking questions and problem-solving when information is unclear
Team-focused and willing to support both the billing department and clinic operations
Patient-centered, even when working behind the scenes
Reliable, professional, and consistent

Responsibilities

Verify insurance eligibility and benefits for new evaluations, current patients, and upcoming appointments
Create and maintain accurate insurance benefit information in the patient record
Obtain required authorizations for physical therapy services
Track authorization status, visit limits, expiration dates, and payer requirements
Communicate authorization updates, benefit details, and potential barriers to the appropriate clinic or billing team member
Review schedules to ensure patients have the required insurance verification and authorization in place before treatment
Monitor authorization work queues, fax queues, payer portals, and related communication channels
Follow up with insurance companies, providers, and referral sources as needed
Document all insurance and authorization activity clearly and accurately
Support denial prevention by identifying missing or incorrect insurance information before claims are submitted
Assist with provider credentialing and recredentialing processes with commercial insurance carriers, government payers, and other contracted networks
Maintain and track provider credentialing records, applications, expirations, CAQH profiles, and supporting documentation
Support company and clinic credentialing needs, including payer enrollments, location updates, and ongoing participation requirements
Communicate with insurance payers regarding credentialing status, application follow-up, and enrollment requirements
Maintain accurate credentialing files and ensure timely submission of required documentation
Assist with billing department projects, payer updates, and process improvements as needed
Maintain patient confidentiality and follow HIPAA standards at all times