Revenue Cycle Coordinator

Socket.dev; Fairlawn (OH); On-site; USD 42,000 - 66,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Life Insurance

Short and Long Term Disability

401(K) with safe harbor match

PTO

7 paid holidays

Employee Assistance Program

Job summary

LLA Therapy is seeking an experienced Revenue Cycle Coordinator to join our pediatric therapy team in Ohio. You will focus on insurance verification and benefits, prior authorizations, and managing denials and appeals.

The ideal candidate tackles problems, takes ownership, researches issues, and drives them to resolution, collaborating with billing, scheduling, and clinical staff. Responsibilities include verifying benefits, reviewing outpatient coverage, obtaining authorizations, resolving

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 preferred.
• Understanding of CPT codes, medical terminology, insurance terminology, and healthcare billing processes.
• Experience with insurance company websites and payer portals.
• Strong problem-solving and organizational skills.
• Excellent written and verbal communication; ability to work independently and with teams.

Responsibilities

• Verify patient benefits before services begin and during treatment.
• Review coverage for outpatient therapies (occupational, physical, and speech).
• Identify coverage issues affecting services or reimbursement.
• Maintain up-to-date insurance information.
• Communicate benefit information clearly with families and staff.
• Research and resolve discrepancies between verified benefits and claims.
• Obtain initial prior authorizations and monitor expiration dates.
• Submit clinical documentation to insurance companies and follow up on authorizations.
• Review denied claims and determine root causes; prepare appeals when needed.
• Track denials and follow up to resolution; identify denial trends for leadership.
• Collaborate with billing, scheduling, and clinical teams to prevent issues.

Skills

Attention to detail

Organizational skills

Written and verbal communication

Problem-solving

Independent work

Team collaboration

Education

High school diploma or GED

Tools

Payer portals

CPT codes knowledge

Job description

Description

About our Company

With over 30 years of pediatric therapy experience, LLA Therapy’s motto is: Helping Kids Shine Their Brightest! In order to accomplish our goal we pride ourselves on effective and streamlined communication, ongoing mentoring and support, collaboration between staff and providing our professionals with the materials and tools they need to succeed.

Position Summary

We are looking for an experienced, detail-oriented Revenue Cycle Coordinator to join our growing pediatric therapy team. This role focuses on insurance verification and benefits, prior authorizations, claim denials and appeals. The right candidate is more than someone who can work a billing queue. We are looking for a problem solver who takes ownership, asks questions, researches issues, and follows them through to resolution.

Essential Accountabilities

Insurance Verification & Benefits

• Verify patient benefits - deductibles, co-pays, co-insurance, visit limits, authorization requirements, and other limitations before services begin 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.

Prior Authorizations

• 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.

Denials & Appeals

• 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.

Requirements

• 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 preferred.
• Understanding of CPT codes, medical terminology, insurance terminology, and healthcare billing processes.
• Experience working with insurance company websites and payer portals.
• Strong attention to detail and excellent 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.

Benefits for the Revenue Cycle Coordinator

• Medical
• Dental
• Vision
• Life Insurance
• Short and Long Term Disability Insurance
• 401(K) with a competitive safe harbor match
• PTO
• 7 paid holidays
• Employee Assistance Program