Pediatric Revenue Cycle Specialist

Lla-Therapy; Fairlawn (OH); On-site; USD 52,000 - 76,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Life Insurance

Short and Long Term Disability

401(K) with a competitive safe harbor

PTO

7 paid holidays

Employee Assistance Program

Job summary

LLA Therapy in Fairlawn, OH is seeking an experienced Revenue Cycle Coordinator to join our pediatric therapy team. The role emphasizes insurance verification, prior authorizations, and denial management to support accurate and timely reimbursement.

You will work closely with billing, scheduling, and clinical staff, take ownership of resolving issues, and help families understand coverage while maintaining high accuracy and compliance in all billing processes.

Qualifications

• High school diploma or GED required.
• Experience in medical billing, insurance verification, prior authorizations, denial management, or healthcare administration.
• Knowledge of commercial insurance and/or Medicaid managed care.
• Understanding CPT codes, medical terminology, insurance terminology, and healthcare billing processes.
• Experience working with insurance company websites and payer portals.
• Strong attention to detail and organizational skills.
• Strong written and verbal communication skills.
• Excellent problem-solving and critical-thinking skills.
• Ability to manage multiple priorities and meet deadlines.
• Comfortable communicating directly with insurance companies.
• Self-motivated and able to work independently.
• Team-oriented and willing to collaborate across departments.
• Resourceful and willing to think outside the box when solving problems.
• Comfortable learning new software, systems, and payer processes.

Responsibilities

• Verify patient benefits before services and throughout treatment.
• Review coverage for outpatient services (occupational, physical, and speech therapy).
• Identify potential coverage issues that could affect patient services or reimbursement.
• Maintain accurate and up-to-date insurance information.
• Communicate benefit information clearly and professionally with families and internal team members.
• Research and resolve discrepancies between verified benefits and actual claim processing.
• Obtain initial prior authorizations for therapy services.
• Submit clinical documentation and supporting information to insurance companies.
• Monitor authorization units, approved dates, and expiration dates.
• Proactively request authorization renewals before existing authorizations expire.
• Follow up with insurance companies regarding pending authorization requests.
• Communicate authorization status to therapists, scheduling staff, and others as needed.
• Identify and resolve authorization-related issues that may impact claims or patient services.
• Review denied and rejected claims and determine the reason for non-payment.
• Research payer policies, claim history, eligibility, authorization records, and documentation to identify the root cause of denials.
• Determine the appropriate resolution, including claim correction, resubmission, appeal, or payer follow-up.
• Prepare and submit appeals with appropriate supporting documentation.
• Contact insurance companies to research and resolve complex claim issues.
• Track outstanding denials and follow up consistently through resolution.
• Identify recurring denial trends and communicate them to leadership.
• Work collaboratively with billing, scheduling, and clinical teams to prevent issues.

Skills

Attention to detail

Organizational skills

Written communication

Verbal communication

Problem solving

Critical thinking

Multitasking

Teamwork

Independent worker

Education

High school diploma or GED

Job description

LLA Therapy in Fairlawn, OH is seeking an experienced Revenue Cycle Coordinator to join our pediatric therapy team. The role emphasizes insurance verification, prior authorizations, and denial management to support accurate and timely reimbursement.

You will work closely with billing, scheduling, and clinical staff, take ownership of resolving issues, and help families understand coverage while maintaining high accuracy and compliance in all billing processes.