About the Role
We are seeking an experienced Prior Authorization & Eligibility/Benefits Specialist with a strong background in Revenue Cycle Management (RCM) for Physical Therapy (PT), Occupational Therapy (OT), and Speech-Language Pathology (SLP) practices.
This role works directly with outpatient therapy clinics and supports front-end and select mid-cycle RCM functions that are critical to patient access, clean claims, and cash flow. The ideal candidate is trustworthy, detail-oriented, flexible, and hardworking, with the ability to adapt to changing priorities in a fully remote environment.
Key Responsibilities
- Verify insurance eligibility and benefits for PT, OT, and SLP services
- Obtain, manage, and track prior authorizations, including:
- Understanding payer-specific requirements and visit limits
- Submitting accurate and timely authorization requests
- Monitoring approvals, denials, extensions, and expirations
- Communicate clearly and proactively with clinics regarding:
- Authorization status and delays
- Coverage limitations and patient financial responsibility
- Assist the billing team as needed, including:
- Resolving claim rejections related to eligibility, authorization, or demographic issues
- Performing follow-ups on unpaid or rejected claims tied to front-end errors
- Support care plan follow-ups, including tracking plan expirations and required documentation
- Assist with patient payment collection efforts when needed, including:
- Verifying balances and coverage
- Coordinating with clinics on patient responsibility
- Maintain accurate documentation in EMRs, billing systems, and payer portals
- Collaborate closely with clinical, billing, and operations teams to reduce denials and delays in care
- Follow established workflows while remaining flexible to support overall RCM operations
Required Qualifications
- Minimum 3 years of RCM experience in a related healthcare field
- Proven experience with prior authorizations and eligibility/benefits verification
- Strong understanding of outpatient rehab services:
- Physical Therapy (PT)
- Occupational Therapy (OT)
- Speech-Language Pathology (SLP)
- Experience working with commercial insurance, Medicare Advantage, and managed Medicaid plans
- Strong attention to detail and excellent organizational skills
- Clear written and verbal communication skills
- Ability to work independently and manage multiple priorities in a remote environment
- High level of integrity and professionalism when handling PHI
Preferred Qualifications
- Experience working directly with therapy clinics or multi-site practices
- Familiarity with common rehab EMRs, billing systems, and payer portals
- Exposure to claim follow-ups and denial prevention strategies in outpatient rehab
What We Offer
- 100% remote role
- Supportive and collaborative RCM leadership
- Competitive salary ($850–$950 depending on experience)
- Opportunity to work cross-functionally within RCM and gain broader operational exposure
- Long-term stability and growth within a specialized rehab RCM team
If you have deep rehab RCM experience, thrive in a flexible environment, and enjoy supporting clinics beyond just one function, we’d love to hear from you.
3 messages remaining. St
Job Type: Full-time
Pay: Php40,000.00 - Php50,000.00 per month
Benefits:
Work Location: Remote
