Verification Specialist

Verification Specialist – Physical Therapy Department CentraState Medical Center is seeking a Verification Specialist to support its Physical Therapy department. The role involves registering and scheduling patients, pre‑screening financial responsibilities, securing consents and insurance information, verifying coverage, and obtaining pre‑certification authorization. Responsibilities Uses critical thinking skills to verify each account in the hospital registration system following departmental procedures and ensuring compliance with regulations. Obtains and coordinates benefits entry into the computer software system according to industry standards. Documents all communications with patients, families, insurance companies, and physicians in the computer system. Ensures quality checks and reviews each account for correct information. Coordinates with insurance companies, patients, physicians, and employers to verify coverage and obtain pre‑certifications and referral requirements. Facilitates discussions with physicians and staff about account status and actions; documents all communications. Communicates financial responsibilities to patients/families professionally and records all interactions. Applies tertiary clinical knowledge for procedures, surgeries, and admissions under verification. Uses TRACE to record outgoing verification calls to insurance companies. Trains staff on insurance company websites for accurate coverage verification and online authorization, maintaining security access. Captures insurance website data via PIXCERT software and records all findings. Utilizes available resources—prior patient records, charity care lists, Medicaid eligibility criteria, and Medicare secondary payor information—to verify accounts. Investigates self‑pay, workers’ compensation, no‑fault, and secondary coverage using appropriate rules and records findings. Completes and sends required forms for verification; manages Medicaid requirements, 21‑day notices, and ABN submissions. Reverifies denied accounts and works with supervisor to resolve or appeal. Maintains productivity within departmental guidelines. Qualifications High school diploma or equivalent required. Hospital experience in registration or billing preferred. Knowledge of medical terminology. Strong customer service skills. Benefits Medical, dental, vision, and prescription coverage (30‑hour workweek minimum). Life & AD&D insurance. Long‑term disability (with optional supplemental coverage). 403(b) retirement plan with employer match. 401(a) retirement plan with employer contribution. Paid time off. Tuition reimbursement. Well‑being rewards. Employee assistance program. Fertility coverage and healthy pregnancy program. Flexible spending & commuter accounts. Pet, home & auto, identity theft and legal insurance. Growth opportunity and workforce development initiatives. Continuing education/onsite training. Warm, collaborative culture focused on patient care. Concierge services with work & family benefits. Magnet recognition. Compensation Compensation Range: $18.00 - $28.80 per hour. #J-18808-Ljbffr