Authorization & Insurance Verification Specialist

Authorization & Insurance Verification Specialist

Peak Performance Physical Therapy is looking for a detail-oriented, dependable, and patient-focused team member to join our Billing Department as a Full-Time Authorization & Insurance Verification Specialist.

This role is an important part of the patient experience and overall revenue cycle process. The Authorization & Insurance Verification Specialist helps ensure patients are set up for care with accurate insurance information, timely authorizations, and clear communication between departments. This position supports our clinics, providers, intake team, and billing team by helping reduce delays in care and keeping patient accounts accurate from the start.

The Authorization & Insurance Verification Specialist is responsible for verifying patient insurance benefits, obtaining and tracking authorizations, maintaining accurate documentation, and communicating insurance-related information to the appropriate team members. This role requires strong attention to detail, follow-through, organization, and the ability to work collaboratively in a fast-paced healthcare environment.

• Verify insurance eligibility and benefits for new evaluations, current patients, and upcoming appointments
• Create and maintain accurate insurance benefit information in the patient record
• Obtain required authorizations for physical therapy services
• Track authorization status, visit limits, expiration dates, and payer requirements
• Communicate authorization updates, benefit details, and potential barriers to the appropriate clinic or billing team member
• Review schedules to ensure patients have the required insurance verification and authorization in place before treatment
• Monitor authorization work queues, fax queues, payer portals, and related communication channels
• Follow up with insurance companies, providers, and referral sources as needed
• Document all insurance and authorization activity clearly and accurately
• Support denial prevention by identifying missing or incorrect insurance information before claims are submitted
• Assist with provider credentialing and recredentialing processes with commercial insurance carriers, government payers, and other contracted networks
• Maintain and track provider credentialing records, applications, expirations, CAQH profiles, and supporting documentation
• Support company and clinic credentialing needs, including payer enrollments, location updates, and ongoing participation requirements
• Communicate with insurance payers regarding credentialing status, application follow-up, and enrollment requirements
• Maintain accurate credentialing files and ensure timely submission of required documentation
• Assist with billing department projects, payer updates, and process improvements as needed
• Maintain patient confidentiality and follow HIPAA standards at all times

• Previous experience in healthcare billing, insurance verification, authorizations, credentialing, patient accounts, or front office healthcare support preferred
• Familiarity with insurance terminology, benefits, referrals, authorizations, deductibles, copays, coinsurance, visit limits, and payer enrollment processes preferred
• Experience with provider credentialing, CAQH maintenance, payer portals, and insurance enrollment systems preferred
• Experience with EMR systems, payer portals, fax queues, and Microsoft Office/Excel helpful
• Strong written and verbal communication skills
• Ability to maintain accuracy while working in a busy environment

• Highly organized and detail-oriented
• Comfortable working with insurance information, payer portals, credentialing systems, and documentation requirements
• Able to manage multiple tasks, deadlines, and follow-up items throughout the day
• Strong in follow-through and communication
• Comfortable asking questions and problem-solving when information is unclear
• Team-focused and willing to support both the billing department and clinic operations
• Patient-centered, even when working behind the scenes