Insurance Verification & Authorization Specialist
Virtual Rockstar Careers
full-time
Posted on:
Location Type: Remote
Location: North Carolina • United States
Visit company websiteExplore more
Salary
💰 $6 - $7 per hour
About the role
- Verify insurance benefits prior to the patient’s initial evaluation and before services are rendered.
- Confirm eligibility, in-/out-of-network coverage, co-pays, co-insurance, deductibles, out-of-pocket max, and therapy-specific limitations.
- Determine and document visit limits, frequency restrictions, referrals, and benefit caps.
- Clearly document benefits so the clinical/admin team can interpret the information without confusion.
- Communicate findings to the team in a way that supports confident scheduling and patient conversations.
- Identify when authorizations are required for skilled physical therapy services.
- Obtain and submit prior authorizations using payer portals, phone calls, or fax-based processes.
- Track authorization status, approved visit counts, start/end dates, and ensure approvals are received prior to visits when required.
- Monitor for expiring visit counts or end dates and initiate re-authorizations proactively to prevent gaps in care.
- Escalate issues quickly when authorization is delayed, denied, or unclear.
- Send claim batches as requested and support follow-up on claims when needed.
- Assist with billing-related insurance follow-up, including unpaid claims, denials, and appeals support (as assigned).
- Communicate with payers to clarify benefits, coverage, authorization requirements, and claim status.
- Maintain accurate logs and documentation for all payer calls, outcomes, and next steps.
- Maintain accurate patient insurance records and ensure all required information is captured and updated.
- Communicate daily with the team through the EMR and/or Microsoft Teams to resolve verification or authorization issues quickly.
- Protect patient privacy and confidentiality in all communication and documentation.
Requirements
- Proven experience with insurance benefits verification and prior authorizations in a healthcare setting (physical therapy experience strongly preferred).
- Strong knowledge of commercial insurance and therapy-related benefit structures.
- Comfortable making payer calls, navigating insurance portals, and resolving discrepancies.
- Strong documentation skills: able to record benefits clearly and accurately so others can interpret and use the information.
- Confident decision-making and interpretation skills—this role requires someone who can think critically, not someone who simply reads the same screen repeatedly.
- Ability to ask questions, challenge unclear information, and advocate for accurate outcomes.
- Strong organizational skills and ability to manage multiple patients, authorizations, and follow-ups daily.
- Must speak clear, fluent English and communicate confidently with insurance representatives and clinic staff.
- Comfort using Microsoft tools and working in Google Chrome; ability to learn additional systems as needed.
- Preferred communication: phone and Microsoft Teams messaging.
Benefits
- Competitive salary commensurate with experience
- Opportunities for professional development and growth
- Work in a dynamic and supportive team environment
- Make a meaningful impact by helping to build and strengthen families across the globe.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
insurance benefits verificationprior authorizationsdocumentation skillsclaim follow-upbilling-related insurance follow-upcritical thinkingdecision-makingadvocacy for accurate outcomespatient insurance record maintenanceauthorization tracking
Soft skills
strong communicationorganizational skillsproblem-solvingability to ask questionsconfident decision-makingability to manage multiple tasksclear and fluent Englishinterpersonal skillsteam collaborationability to challenge unclear information