Authorization Representative

Physical Rehabilitation Network, LLC.; Watauga (TX); Ibrido; USD 28.000 - 30.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical benefits

Vision benefits

Dental benefits

Paid time off

Descrizione del lavoro

Physical Rehabilitation Network, Inc. is hiring an Authorization Representative to obtain, verify, and document insurance authorizations for medical procedures.

This full-time hybrid role ensures compliance with payer requirements, helps prevent denials, and supports patient access to care by coordinating with providers, billing, and clinical teams. The ideal candidate has healthcare authorization experience, knowledge of CPT/ICD-10, and proficiency with EHR and payer portals, with strong

Competenze

• High school diploma or equivalent.
• Experience in healthcare authorization, medical billing, patient access, or insurance verification.
• Strong understanding of medical terminology, CPT/ICD-10 codes, and insurance regulations.
• Excellent communication, organization, and problem-solving skills.
• Proficiency with EHR systems, payer portals, and standard office software.
• Experience working with multiple insurance payers (Medicare, Medicaid, commercial plans, etc.) preferred.

Mansioni

• Secure prior authorizations and pre-certifications from insurance companies within required timeframes.
• Review medical necessity guidelines and payer policies to determine required documentation.
• Communicate with providers, clinical staff, and insurance carriers to obtain required details for authorization approval.
• Accurately document authorization numbers, effective dates, status updates, and payer information in EHR or practice management systems.
• Maintain organized and compliant records according to HIPAA standards.
• Provide updates to scheduling, billing, and clinical teams regarding authorization status.
• Collaborate with clinical teams to support appeals or additional documentation requests.
• Adhere to federal, state, and payer-specific regulations.
• Monitor policy changes from insurance carriers and notify internal teams as needed.
• Assist in resolving claim denials related to missing or incorrect authorizations.

Conoscenze

Healthcare authorization

Medical terminology CPT/ICD-10

Communication skills

Organization skills

Problem-solving

EHR systems proficiency

Formazione

High school diploma or equivalent

Strumenti

Payer portals

Office software

Descrizione del lavoro

Job Title: Authorization Representative
Pay: $20-22/hr
Full Time, Hybrid

Physical Rehabilitation Network (PRN) and its Family of Brands is seeking to recruit & hire a Authorization Representative.

About Us

PRN brings together some of the most trusted PT brands across the West and Central U.S. Whether in the clinic or behind the scenes, we’re all about personalized care, smart clinical insight, and making every patient feel supported from start to finish.

About the Role

The Authorization Representative is responsible for obtaining, verifying, and documenting insurance authorizations and pre-certifications for medical procedures, services, or medications. This role ensures compliance with payer requirements, prevents claim denials, and supports efficient patient access to care.

Duties & Responsibilities

Insurance Verification & Authorization

• Secure prior authorizations and pre-certifications from insurance companies within required timeframes.
• Review medical necessity guidelines and payer policies to determine required documentation.
• Communicate with providers, clinical staff, and insurance carriers to obtain required details for authorization approval.

Documentation & Data Entry

• Accurately document authorization numbers, effective dates, status updates, and payer information in electronic health record (EHR) or practice management systems.
• Maintain organized and compliant records according to HIPAA standards.

Communication & Coordination

• Provide updates to scheduling, billing, and clinical teams regarding authorization status.
• Collaborate with clinical teams to support appeals or additional documentation requests.

Compliance & Quality Assurance

• Adhere to federal, state, and payer-specific regulations.
• Monitor policy changes from insurance carriers and notify internal teams as needed.
• Assist in resolving claim denials related to missing or incorrect authorizations.

Skills & Qualifications

• High school diploma or equivalent
• Experience in healthcare authorization, medical billing, patient access, or insurance verification
• Strong understanding of medical terminology, CPT/ICD-10 codes, and insurance regulations
• Excellent communication, organization, and problem-solving skills
• Proficiency with EHR systems, payer portals, and standard office software
• Experience working with multiple insurance payers (Medicare, Medicaid, commercial plans, etc.) preferred

We offer a comprehensive and competitive compensation package designed to support both personal and professional well being. Team members enjoy full scale benefits—including robust Medical, Vision, and Dental plans—along with paid time off, clinical incentive opportunities, and student loan repayment options. We are committed to your continued growth and success, providing professional development resources and ongoing clinical education support.

At PRN, you’ll be part of a supportive, mission driven environment dedicated to excellence in patient care and the success of every member of our team.

Note: This job description is a general outline of responsibilities and requirements. Specific duties may vary based on the needs of management.

Disclaimer

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.