Authorization and Benefits Specialist
Core
Verify insurance benefits and eligibility, manage patient information, and prepare documentation for patient evaluations.
Role type
Insurance and Authorization Verification Specialist
Builds
Patient support operations for a physical therapy clinic
Domain
Healthcare / Insurance Administration
Deliverable
client delivery
Required skills
Benefit verification, authorization management, payer portal navigation, EMR/EHR proficiency, data entry accuracy, compliance auditing
Preferred skills
Commercial insurance knowledge, Medicare/Medicaid experience, managed care plan familiarity, workflow improvement
Technologies
Availity, UHC, Cigna, Aetna, EMR/EHR systems
Responsibilities
Completing benefit checks and interpreting cost-sharing details; managing authorizations and pre-auth rules; monitoring referrals and visit limits; performing audits for accuracy and compliance
Seniority
Individual Contributor, operational support