Verification/Authorization Specialist
Core
Manage the prior authorization process for physical, occupational, speech therapy, massage, and acupuncture services by collecting documentation, contacting clients and payors, and ensuring approvals before service delivery.
Role type
Authorization Specialist (Healthcare Administration)
Builds
Prior and retro authorization requests for therapy services
Domain
Healthcare / Physical Therapy / Insurance Administration
Deliverable
client delivery
Required skills
Documentation management, ICD-10 code verification, data entry, HIPAA compliance, patient communication, insurance carrier liaison, report generation, NPI management
Preferred skills
Problem-solving, multitasking, stress management, proficiency in Word/Outlook/Excel
Responsibilities
Collect necessary documentation for prior authorizations, contact clients and insurance companies for approvals, input authorizations and update system screens, provide data entry for level of care, communicate authorization status and appeals to patients and providers, maintain documentation of processes, assist staff with authorization issues, generate expected collections reports, maintain physician NPIs
Seniority
Mid-level, individual contributor