Outpatient PT Insurance & Billing Specialist

FYZICAL Therapy & Balance Centers - Concord, NC; Concord (NC); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

401(k)

Flexible schedule

Job summary

FYZICAL Therapy & Balance Centers - Concord, NC is seeking a dedicated Insurance Verification and Billing Specialist to own the clinic’s insurance cycle. You will verify coverage, secure authorizations, post payments, and work denials to keep care uninterrupted.

This role collaborates with front desk, uses payer portals, and supports accurate claims with CPT/ICD-10 coding, while maintaining HIPAA standards and providing clear communication with patients and payers.

Qualifications

• 2+ years medical insurance verification and billing experience.
• Working knowledge of CPT/ICD-10, EOBs/ERAs, and payer portals (Availity, NaviNet, etc.).
• Strong understanding of Medicare and commercial payer rules.
• Organized, self-directed, comfortable working independently on limited hours.
• HIPAA-compliant private workspace, reliable internet, own computer.

Responsibilities

• Insurance verification: confirm active coverage and eligibility for new patients and plan changes, 48+ hours before the evaluation.
• Benefit verification: document PT outpatient benefits and flag patient responsibility to front desk.
• Authorizations: obtain prior auths and re-auths; track approved visits and expiration dates.
• Claims: review charges for coding/modifier accuracy and submit clean claims timely.
• Payment posting: post ERAs/EOBs and reconcile against expected reimbursement.
• Denials & appeals: research denials, correct and resubmit, write appeals.
• AR follow-up: work aging reports, resolve stalled claims by phone and payer portal.
• Payer communication: clinic's contact with commercial, Medicare, Medicare Advantage, Medicaid, and workers' comp/auto payers.
• Patient balances: support patient statements and answer billing questions.
• Reporting: weekly update — verifications done, auths pending, denials worked, AR movement.

Skills

Insurance verification

Medical billing

CPT/ICD-10

Payer portals

HIPAA compliance

Tools

WebPT

Raintree

Prompt

Availity

NaviNet

Job description

FYZICAL Therapy & Balance Centers - Concord, NC is seeking a dedicated Insurance Verification and Billing Specialist to own the clinic’s insurance cycle. You will verify coverage, secure authorizations, post payments, and work denials to keep care uninterrupted.

This role collaborates with front desk, uses payer portals, and supports accurate claims with CPT/ICD-10 coding, while maintaining HIPAA standards and providing clear communication with patients and payers.