Verification Specialist (Remote)

PT Solutions
1dRemote

About The Position

The Verification Specialist 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. 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! To see what #PTSLife is like, visit Instagram, Facebook, and LinkedIn.

Requirements

  • 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.

Responsibilities

  • 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.
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