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We are seeking a detail-oriented Insurance Verification and Patient Support Specialist with expertise in PPO plans. This individual will play a key role in supporting our patients by thoroughly verifying insurance benefits and clearly communicating coverage details to patients. The successful candidate will understand how PPOs work, especially as they relate to therapy services, and will be able to guide patients through the financial and administrative steps of their care.
Job Responsibility:
Verify insurance benefits, with a specific focus on PPO plans, and accurately determine patient copays and out-of-pocket expenses
Clearly explain coverage outcomes to clients, including copay amounts and what is covered under their PPO plan
Educate patients on the necessity of having a physician’s prescription for Occupational Therapy (OT) and Speech Therapy, even when covered by a PPO plan
Guide patients through the scheduling process, ensuring they understand each step and any prerequisites for appointments
Serve as a knowledgeable resource for patients regarding insurance plan requirements, authorizations, and general billing questions
Work cross-functionally with clinical and administrative teams to ensure a seamless patient experience from benefit verification through appointment scheduling
Requirements:
Demonstrated experience with insurance verification, with strong knowledge of PPO plans and medical billing processes
Ability to explain insurance and healthcare concepts in clear, patient-friendly language
Excellent communication, organizational, and customer service skills
Experience in healthcare administration, medical scheduling, or related field preferred