Authorization & Insurance Verification Specialist

About the role

Department: Billing
Status: Full-Time
Location: Lansing / Billing Department
Company: Peak Performance Physical Therapy

Responsibilities

• 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

Requirements

• 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

Qualifications

• 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
• Reliable, professional, and consistent