Pediatric Therapy Outpatient Insurance Specialist

Amazing Care Pediatric Outpatient Therapy•Aurora, CO

10d•Onsite

About The Position

At Amazing Care Pediatric Outpatient Therapy, we provide exceptional care and support to children with various developmental and therapeutic needs. Our team of skilled professionals is committed to creating a nurturing environment where every child can thrive. We are seeking a detail-oriented and motivated Insurance Specialist to join our dynamic team and contribute to the financial health of our practice. The Insurance Specialist plays a crucial role in financial operations related to patient services. This position is responsible for ensuring accurate and timely processing of billing, claims, payments, and collections by performing the key responsibilities listed below. The ideal candidate will have an understanding of insurance eligibility/benefits and authorizations, excellent analytical skills, exceptional attention to detail, and the ability to communicate effectively with patients, insurance companies, and internal staff.

Requirements

High school diploma or equivalent; college experience preferred but not required.
Experience in an office/administrative role, preferably in a pediatric or therapy setting preferred.
Knowledge of insurance policies and procedures.
Proficient in using electronic medical records (EMR), billing systems, excel and Teams.
Excellent communication and interpersonal skills.
Strong attention to detail and organizational skills.
Ability to work independently and as part of a team.
Problem-solving skills and the ability to handle challenging situations with professionalism and empathy.

Nice To Haves

college experience preferred
Experience in a pediatric or therapy setting preferred

Responsibilities

Utilize payer portals and place phone calls to carriers to verify patient insurance coverage and benefits.
Obtain necessary documentation required for authorization.
Secure authorizations for new and ongoing patients.
Maintain accurate and up-to-date records for each patient’s account related to coverage, benefits, and eligibility.
Communicate with patients regarding their accounts, providing clear and concise explanations of benefits, expected charges and other claims related questions.
Maintain up-to-date knowledge of insurance policies, procedures, and changes affecting the practice.
Review and resolve claim denials, by generating evidence-based appeals to submit to insurance carriers.
Other duties as assigned by supervisor.