Patient Benefits Coordinator- Salisbury MD

Patient Benefits Coordinator

Position Overview: We are seeking a motivated, detail-oriented individual to join our team as a Physical Therapy Patient Benefits Coordinator. This role is responsible for verifying insurance eligibility and benefits, obtaining and maintaining required authorizations, monitoring authorization limits and expiration dates, and communicating insurance-related information to patients and internal team members.

Core Education & Experience:

• Education: High school diploma, GED, or equivalent is required;
• Experience: Generally 1 to 3 years of experience in medical insurance verification, medical billing, or healthcare administration.
• Electronic Health Records (EHR): Familiarity with electronic health record systems.

Technical Knowledge & Skills:

• Medical Terminology & Coding: Working knowledge of medical terminology, CPT procedure codes, and ICD-10 diagnosis codes.
• Insurance Payer Portals: Ability to navigate commercial insurance carrier websites, Medicare portals, and regional Medicaid programs, including Maryland Medicaid and Delaware state-managed plans.
• EMR Systems & Workflows: Familiarity with Electronic Medical Record (EMR) systems, including data entry, documentation, patient account management, and understanding of system workflows.
• Computer & Software Proficiency: Strong basic computer skills, data entry, and the ability to learn and navigate medical billing and practice management software.
• Pre-Authorizations & Certifications: Experience obtaining clinical pre-certifications and prior authorizations through insurance carrier phone systems and online portals. Ability to monitor authorization requirements, approved visits, expiration dates, and remaining visits.
• Regulatory Compliance & HIPAA: Understanding of and strict adherence to HIPAA regulations, patient confidentiality, and applicable privacy requirements.
• Ability to multitask and work independently in a fast-paced environment while maintaining quality and accuracy

Soft Skills:

• Communication: Clear verbal and written skills to talk with patients regarding out-of-pocket costs, and to resolve eligibility discrepancies with insurance carriers.
• Attention to Detail: High accuracy in entering policy numbers, group numbers, effective dates, and benefit tiers to prevent claim denials. Review and determine insurance plan benefit information for scheduled services, including co-insurance and deductibles; compare and communicate in and out of network benefits accordingly.

Patient Navigation and Notification:

• Interpret insurance verification information to estimate patient financial responsibility amounts for scheduled services and inpatient stays.
• Act as a liaison to ensure all of the appropriate custodial issues are resolved prior to the patient's arrival.

This position can be a combined in-person/virtual position, need to live in the area of Annapolis, Salisbury MD or Lewes DE.

Join a team where you can grow, specialize, and make a difference! For over 27+ years, Aquacare & Fitness Forum Physical Therapy has proudly delivered premier outpatient physical therapy services across Maryland and Delaware as a locally owned and operated practice.

We're committed to helping our clinicians specialize in their fields of interestsupporting professional growth through mentorship and continuing education.

Our specialty services are designed to meet the diverse needs of our community and include:

Specialty Areas: Orthopedic Rehabilitation LSVT BIG for Parkinson's Aquatic Therapy Sports Rehabilitation (Aquacare Athletics) Balance & Vestibular Therapy Dance Rehabilitation Lymphedema Treatment Neurological Rehabilitation Pelvic Floor Therapy Women's Health

At Aquacare & Fitness Forum PT, you'll be part of a collaborative, patient-centered team that values quality care and clinical excellence.

Aquacare Physical Therapy