Workers Compensation Authorization & Verification Specialist

ivyhealth; United States; Remote; USD 28,000 - 32,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401k with match

Disability & life insurance

Pet insurance discounts

Paid parental leave

Gym discounts

Mental health resources

Generous PTO

Job summary

Ivy Health is seeking a Workers Compensation Authorization and Verification Specialist in New York to join our team and optimize authorization workflows. You will collaborate with the WC Authorization and Verification Team Lead, front desk staff, and external vendors to ensure timely authorizations and reimbursements for patients and providers.

The role emphasizes improving workflows, maintaining payer/state guideline compliance, and delivering high-quality service.

Qualifications

• 2-3 years experience in pre-auth verification.
• Experience with Workers Compensation insurance in therapy arena preferred.
• Excellent written and verbal communication skills.
• Customer service experience.
• Proficient in Microsoft applications.

Responsibilities

• Submit authorization requests timely within EMR following payer and state guidelines.
• Specialize in Workers Compensation Financial Class and state/payer specifics.
• Coordinate with Front Desk/WCCS to ensure documentation for submission.
• Provide feedback on authorization timelines or process improvements.
• Address authorization/verification queries from teammates and payers.
• Address denials promptly and provide prevention feedback.

Skills

Workers Compensation familiarity

Pre-auth verification experience

Customer service

Written and verbal communication

Microsoft Office

Multitasking

Remote work capability

Problem solving

Tools

EMR systems

BI reporting

Job description

State of Location: New York

Position Summary: At Ivy Health, we're "All About the People"! As a Workers Compensation (WC) Authorization and Verification Specialist, you will play a crucial role in our mission to help enable people to live their lives to the fullest.

Job Description

The Workers Compensation (WC) Authorization and Verification Specialist will report to the WC Authorization and Verification Team Lead and will work in combination with front office teammates and any external authorization and verification vendors to ensure Ivy Health’s authorization and verification processes and workflows are executed successfully, set goals and best practices are achieved, and the risk of lost revenue is minimized. In this role, you will be driving both internal and external customer satisfaction through a focus on faster and more efficient reimbursement. The ideal candidate will not only ensure a positive experience for patients, providers, and fellow teammates but will also be a key contributor in optimizing and standardizing authorization and verification workflows within Ivy Health.

Your responsibilities will include:

• Submit authorization requests timely within EMR, following payer and state specific guidelines
• Specialize in Workers Compensation Financial Class and fluidity within different state and payer specifics
• Partner with Front Desk teammates and/or Workers Compensation Centralized Scheduling (WCCS) teammates within clinics to ensure appropriate and accurate documentation for authorization submission is completed and uploaded for submission
• Provide regular feedback to front desk and/or WCCS regarding areas of opportunity in authorization or verification timeline or process
• Address and respond to authorization or verification related queries from Ivy teammates and WC Payers
• Ensure all authorization and verification related denials are addressed timely and accurately, providing denial prevention feedback to WC Team Lead
• Accurately complete verifications for same day or walk-in patients by contacting the provided insurance via phone, fax, or online portal to obtain outpatient therapy benefits, eligibility, and authorization information
• Request, follow-up, and secure authorizations prior to and during treatment episode for Workers Compensation patients
• Assist with training and education for new A&V teammates as well as ongoing training and education for established team members
• Maintain a professional and collaborative relationship with all teammates and vendors to resolve issues, increase knowledge of insurance requirements, and create standardized workflows
• Run EMR or BI reports as needed to monitor maximum benefits, missing authorization, or other areas of focus as determined by the A&V Team Lead
• Attend and participate in Department and Organizational meetings to discuss departmental goals and progress
• Perform other duties as assigned by leadership staff

To excel in this role, you should possess:

• Experience with Workers Compensation insurance in the therapy arena preferred
• Demonstrates flexibility in responding to priorities and organizational change.
• Demonstrates ability to work under pressure and follow through on assignments
• 2-3 years previous experience in pre-auth verification; experience with obtaining authorizations, referral coordination and patient services preferred
• Ability to multi-task, prioritize needs to meet required timelines.
• Customer service experience
• Effective written and verbal communication skills.
• Solution oriented mindset and ability to use critical thinking and analytical skills
• Ability to use standard office equipment to include copiers, fax machines, and other methods of electronic communications.
• Open availability Monday through Friday from 8am-5pm EST
• Ability to self-motivate and focus in a remote position
• Proficient in Microsoft applications

Why choose Ivy Health?

Exceeding Expectations:Deliver best-in-class care and witness exceptional patient outcomes.

Empowering Values:Live by values that prioritize teamwork, growth, and serving others.

Compensation Range

$20.00 - $23.00 per hour. This position is also eligible for a bonus.

Full Benefits in Your First 30 Days

• Medical, dental, vision insurance
• 401k with company matching contribution
• Disability & life insurance
• Pet insurance discounts for your fur babies
• Paid parental leave and maternity leave
• Gym and wellness discounts
• Free mental health + financial services
• Generous PTO Program & 6 paid holidays annually

Equal Opportunity

We are an equal opportunity employer, committed to diversity and inclusion in all aspects of the recruiting and employment process.

Actual salaries depend on a variety of factors, including experience, specialty, education, and organizational need. Any listed salary range or contractual rate does not include bonuses/incentive, differential pay, or other forms of compensation or benefits.

ivyhealth.com

Ivy Health Overview

Welcome to Ivy Health Join us on our mission to inspire & enable people to live life to the fullest! Ivy Health is a growing team of orthopedic and pediatric outpatient physical, occupational, speech, and ABA therapy clinics with over 500 locations throughout the Northeast, Mid-Atlantic, Midwest, and Southeast. Through a shared commitment to clinical excellence, we work as a unified team to serve each person to the best of our ability. Combining our clinical objectives and company culture, you can see why Ivy is committed to providing endless opportunities to every teammate through professional development tracks, continuing education, leadership development, residency cohorts, mentorship programs, and many other resources.