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Hybrid Insurance & Billing Specialist (Part-Time)
FYZICAL Therapy & Balance Centers - Concord, NC
Cabarrus County, North Carolina, United States | RemoteUSD20 - USD25 / HOURRemote Solely
AI Summary
The specialist manages the full insurance cycle for an outpatient physical therapy clinic, including verification, authorizations, and claims processing. They are responsible for resolving denials, managing aging accounts receivable, and maintaining clear communication with various payers.
Candidates must have at least 2 years of experience in medical insurance verification and billing with a strong understanding of CPT/ICD-10 coding. Proficiency in payer portals and the ability to work independently in a remote, HIPAA-compliant environment are required.
Job Details
Job Type: FULL TIME
Visa Sponsorship: No
Salary: USD20 - USD25 / HOUR
Education: professional certificate
Work Arrangement: Remote Solely
Experience Level: 2 - 5 years
Hours: 40 hrs/week
Language: English
Benefits
401(k)Flexible schedule
Key Skills
Insurance verificationMedical billingCPT codingICD-10 codingAuthorization managementClaims submissionDenial managementAppealsAccounts receivablePayer communicationPayment postingMedicare regulationsCommercial payer rulesEMR systemsHIPAA compliance
Benefits:
Owns the insurance cycle for an outpatient physical therapy clinic: verifying coverage before patients are seen, securing authorizations, getting clean claims out, and working denials and aging AR until paid. Works with the clinic's front desk/scheduling team and reports to the Managing Partner.
Key Responsibilities
• Insurance verification: confirm active coverage and eligibility for new patients and plan changes, 48+ hours before the evaluation.• Benefit verification: document PT outpatient benefits — deductible/met, copay/coinsurance, OOP max, visit limits, auth/referral requirements — and flag patient responsibility to the front desk.• Authorizations: obtain prior auths and re-auths; track approved visits and expiration dates so care isn't interrupted.• Claims: review charges for coding/modifier accuracy (CPT, ICD-10, GP/KX/59) and submit clean claims timely.• Payment posting: post ERAs/EOBs and reconcile against expected reimbursement.• Denials & appeals: research denials/rejections, correct and resubmit, write appeals.• AR follow-up: work aging reports, prioritizing 60/90+ day balances; resolve stalled claims by phone and payer portal.• Payer communication: clinic's point of contact with commercial, Medicare, Medicare Advantage, Medicaid, and workers' comp/auto payers.• Patient balances: support patient statements and answer billing questions.• Reporting: brief weekly update — verifications done, auths pending, denials worked, AR movement, items needing owner decisions.
Qualifications
Required• 2+ years medical insurance verification and billing experience• Working knowledge of CPT/ICD-10, EOBs/ERAs, and payer portals (Availity, NaviNet, etc.)• Strong understanding of Medicare and commercial payer rules• Organized, self-directed, comfortable working independently on limited hours• HIPAA-compliant private workspace, reliable internet, own computer
Preferred
• Outpatient PT/rehab billing (KX modifier, 8-minute rule, plan-of-care certification)• PT EMR/billing systems (WebPT, Raintree, Prompt, etc.)• Workers' comp and auto/PI claims• CPC, CPB, or similar certification
Success Measures
• 100% of new patients verified before first visit• Zero missed or lapsed authorizations• Clean claim rate 95%+• Steady reduction in 90+ day AR• Denials worked within 7 business days
- 401(k)
- Flexible schedule
Owns the insurance cycle for an outpatient physical therapy clinic: verifying coverage before patients are seen, securing authorizations, getting clean claims out, and working denials and aging AR until paid. Works with the clinic's front desk/scheduling team and reports to the Managing Partner.
Key Responsibilities
• Insurance verification: confirm active coverage and eligibility for new patients and plan changes, 48+ hours before the evaluation.• Benefit verification: document PT outpatient benefits — deductible/met, copay/coinsurance, OOP max, visit limits, auth/referral requirements — and flag patient responsibility to the front desk.• Authorizations: obtain prior auths and re-auths; track approved visits and expiration dates so care isn't interrupted.• Claims: review charges for coding/modifier accuracy (CPT, ICD-10, GP/KX/59) and submit clean claims timely.• Payment posting: post ERAs/EOBs and reconcile against expected reimbursement.• Denials & appeals: research denials/rejections, correct and resubmit, write appeals.• AR follow-up: work aging reports, prioritizing 60/90+ day balances; resolve stalled claims by phone and payer portal.• Payer communication: clinic's point of contact with commercial, Medicare, Medicare Advantage, Medicaid, and workers' comp/auto payers.• Patient balances: support patient statements and answer billing questions.• Reporting: brief weekly update — verifications done, auths pending, denials worked, AR movement, items needing owner decisions.
Qualifications
Required• 2+ years medical insurance verification and billing experience• Working knowledge of CPT/ICD-10, EOBs/ERAs, and payer portals (Availity, NaviNet, etc.)• Strong understanding of Medicare and commercial payer rules• Organized, self-directed, comfortable working independently on limited hours• HIPAA-compliant private workspace, reliable internet, own computer
Preferred
• Outpatient PT/rehab billing (KX modifier, 8-minute rule, plan-of-care certification)• PT EMR/billing systems (WebPT, Raintree, Prompt, etc.)• Workers' comp and auto/PI claims• CPC, CPB, or similar certification
Success Measures
• 100% of new patients verified before first visit• Zero missed or lapsed authorizations• Clean claim rate 95%+• Steady reduction in 90+ day AR• Denials worked within 7 business days