Insurance Verification Specialist - RCM

Job description

Overview
HealthPRO Pediatrics is hiring a RIV/Authorization Coordinator to join our Revenue Cycle team.
In this role, you’ll verify patient insurance benefits, coordinate authorizations, and communicate with patients, therapy teams, and insurance representatives to help ensure patients have the appropriate coverage for therapy services.
Pay: $18–$20/hour
This is a great opportunity for someone with strong communication skills, attention to detail, and an interest in healthcare administration and revenue cycle operations.
Apply today to join the HealthPRO Pediatrics team!
Why Choose HealthPro Heritage?
• Purpose-Driven Work: Be part of a mission-driven organization dedicated to compassionate care and innovative therapy solutions.
• Growth Opportunities: Enjoy continuous learning and development opportunities tailored to support your professional growth.
• Collaborative Culture: Thrive in a supportive environment where teamwork, respect, and open communication are at the heart of everything we do.
• Commitment to Excellence: Join a team recognized for clinical expertise and commitment to delivering high-quality care and outcomes.
• Competitive Benefits Package: Enjoy competitive compensation along with a comprehensive benefits package designed with YOU in mind!

Join Us in Making a Difference
At HealthPro Heritage, we offer a fulfilling career where you can positively impact lives and achieve personal and professional growth. As a therapist-led, diverse organization, we provide clinical services across various settings, including nursing facilities, retirement communities, hospitals, home care, and pediatric schools and clinics. Join us to be part of a team that values your skills, listens to your input, and makes a meaningful difference in the community.
Responsibilities
The RIV/Authorization Coordinator is a key role in ensuring that patients benefits are properly verified for therapy visits. This position is integral to proper RCM function and revenue protection. This position requires great customer service skills, teamwork and the ability to communicate effectively with patients, therapists, insurance company representatives and occasionally Physician offices and/or Home Health centers.
The RIV Specialist helps to communicate benefits eligibility to Program Managers and patients. They are responsible to ensure the appropriate follow-up and communication with Therapy providers and/or vendors.
This position will be responsible for insurance verifications RIV and will report to the Team Lead, Revenue Cycle Manager, Director of Revenue Cycle.
• Performs eligibility verification by entering ticket information into the Vendor system. Obtaining verification documents and uploads them appropriately in the EHR System.
• Verifying insurance benefits via respective payer websites and calling insurances directly.
• Ensures patient financial/consent to treat/HIPPA forms are signed and uploaded to the EHR.
• Enter comments in the EMR/RIV tickets that are clear and concise regarding coverage dates and any policy limits, deductibles, and co-pays, etc.
• Coordinate with providers to ensure all appropriate insurance documentation is uploaded for accurate benefit/eligibility checks.
• Meet daily, weekly, and monthly productivity requirements.
• Complete special projects as assigned by the Director of Revenue Cycle, RCM Manager and RIV Team Lead.

HealthPro Heritage is an Equal Opportunity Employer. We consider all qualified candidates for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other characteristic protected by law. Our employment decisions, including those related to hiring, promotion, and compensation, are made based on individual qualifications, performance, and organizational needs.
Qualifications
• Prior knowledge and experience with CPT and ICD-10 codes is strongly preferred.
• 1 – 2 years’ experience with medical insurance verification and authorization is a plus.
• High school graduate or Equivalent
• Ability to work in a team environment
• Ability to read and interpret documents, medical records, and other related documentation
• Ability to learn new processes and procedures quickly, handle a fast-paced environment, and prioritize tasks based on importance
• Demonstrate excellent written and verbal communication skills
• Sufficient typing skills, high level of proficiency with general office PC applications (i.e., MS Word, MS Excel), Medical Billing Software Systems, and comfort with learning new applications as required