Healthcare Insurance Coordinator (PH | Remote)

1. Verification of Benefits (VOB)

• Contact insurance providers to verify patient eligibility and coverage
• Accurately document payer responses in internal systems
• Flag missing or unclear information for internal review
• Follow payer-specific guidelines (e.g., Medicaid vs. commercial insurance)

2. Initial Authorization Support

• Review patient intake documents and treatment recommendations
• Complete payer-specific authorization request forms
• Assemble and submit packets with supporting documents (e.g., treatment plans, credentials)
• Use payer portals, fax, or email to submit authorizations
• Track confirmation statuses and log any necessary follow-ups

3. Treatment Re-Authorization

• Review clinical documentation and ongoing treatment plans
• Summarize clinical data in alignment with payer requirements
• Ensure all documentation meets compliance standards (e.g., measurable goals)
• Copy and format relevant data (e.g., CPT codes, session logs)
• Coordinate with clinicians for clarification and missing details
• Track submission timelines to avoid lapses in treatment approvals