Rehabilitation- Insurance Verification & Referral Coordinator

Louisiana Orthopaedic Specialists LLC; Lafayette (LA); On-site; USD 25,000 - 41,000; Full time

Job summary

Louisiana Orthopaedic Specialists LLC is seeking a Rehabilitation- Insurance Verification and Referral Coordinator to ensure timely verification of insurance benefits for outpatient physical and occupational therapy services. The role supports the rehabilitation department by managing referrals and scheduling in accordance with policies.

Responsibilities include submitting claims, obtaining authorizations, communicating coverage details to staff and clinicians, and reconciling payments.

Qualifications

• 1–2 years of experience in medical billing or insurance verification, preferably in therapy or outpatient setting.
• Knowledge of CPT, ICD-10 and modifier codes is beneficial.
• Strong communication and coordination with therapists and office staff.

Responsibilities

• Verify patient insurance coverage and therapy benefits prior to treatment.
• Determine authorization requirements and obtain prior authorization as needed.
• Communicate coverage details and out-of-pocket expectations to front office staff and clinicians.
• Prepare and submit accurate electronic and paper claims using CPT, ICD-10, and modifiers.
• Track claim status and address issues early in the billing cycle.
• Research and resolve denied or rejected claims, submitting appeals when needed.
• Coordinate with therapists for documentation to support medical necessity.
• Maintain clear records of verification and billing activity.

Skills

Medical billing

Insurance verification

Communication

Team leadership

Education

High school diploma or equivalent

Medical billing certification (preferred)

Job description

Description

Job Description

Rehabilitation- Insurance Verification and Referral Coordinator

FLSA Status

Non-Exempt

Supervision Received

Rehabilitation Front Office Supervisor

Supervision Exercised

None

Position Summary

The Insurance Verification and Referral Coordinator is responsible for ensuring timely verification of insurance benefits for outpatient physical and occupational therapy services. This dual function role supports the rehabilitation department by appropriately managing referrals, scheduling patients according to departmental policies and procedures.

Duties and Responsibilities

• Verify patient insurance coverage and therapy-specific benefits prior to treatment
• Determine authorization requirements and obtain prior authorization as needed
• Communicate coverage details and out-of-pocket expectations to front office staff and clinicians
• Prepare and submit accurate electronic and paper claims using appropriate CPT, ICD-10, and modifier codes
• Ensure claims are submitted in accordance with payer-specific rules and deadlines
• Track claim status and identify issues early in the billing cycle
• Research and resolve denied or rejected claims
• Submit appeals or corrected claims as needed
• Coordinate with therapists for documentation needed to support medical necessity
• Accurately post insurance and patient payments
• Review EOBs/ERAs and reconcile discrepancies
• Follow up on outstanding claims and aging accounts
• Maintain clear records of all verification and billing activity
• Communicate proactively with therapists, front desk staff, and patients regarding billing issues
• Assist with maintaining and updating payer requirements reference materials

Qualifications

• 1-2 years of experience in medical billing or insurance verification, ideally in a therapy or outpatient setting

Preferred Qualifications

• High school diploma or equivalent required; medical billing certification or associate’s degree preferred.

Core Competencies

• Strong leadership, communication, and interpersonal skills
• Skilled in coaching, staff development, and performance management
• Ability to manage competing priorities, meet deadlines, and drive process improvements
• Discretion in handling confidential personnel and legal matters
• Adaptability to changing regulations and organizational needs

Physical Requirements

• Requires sitting and standing associated with a typical office environment. Some bending and stretching are required.
• Manual dexterity using a calculator and computer keyboard.

Work Environment

Normal office environment