Patient Care Coordinator and Billing Specialist

Position Summary :

We are seeking a detail-oriented Patient Care Coordinator to join our growing pediatric therapy clinic. This role combines patient service excellence with insurance authorization expertise to ensure seamless care delivery for our young patients and their families. The ideal candidate will manage approximately 8,000 quarterly appointments while maintaining exceptional customer service standards. Essential Job Functions Insurance Authorization & Verification - Initiate and complete prior authorizations for occupational therapy, physical therapy, and speech-language pathology services Verify insurance eligibility, benefits, and pre-certification requirements using carrier-specific tools and portals Submit authorization requests via electronic systems, phone, or fax following payer-specific guidelines Monitor pending authorizations and ensure timely approval before scheduled appointments Track and renew expiring authorizations to prevent service interruptions Communicate with insurance companies, case managers, and support coordinators to obtain authorization status and resolve coverage issues Document all insurance interactions and authorization details in patient charts with accuracy and timeliness Stay current on payer requirements and authorization guidelines for pediatric therapy services Advocate for patients by identifying coverage issues and working to resolve barriers to care Patient Services & Front Desk Support Greet patients and families with a warm, professional demeanor Check patients in and out using Electronic Medical Record (EMR) system- Collect patient information, insurance cards, and co-payments Schedule and reschedule appointments as needed Answer phone calls and respond to patient inquiries Maintain patient confidentiality in accordance with HIPAA regulations Billing & Administrative Support Help resolve billing discrepancies and patient account issues Process patient invoices Assist billing department with follow-up on denied or rejected claims Assist billing department with charge and payment posting Support audits and quality reviews with thorough record-keeping Maintain accurate documentation in patient files and databases Coordinate and assist in the therapist credentialing process Skills and Education High school diploma or equivalent; associate degree preferred 2+ years experience in healthcare administration, insurance verification, or patient services Knowledge of medical terminology, particularly related to pediatric therapy services Experience with prior authorization processes and insurance verification Proficiency with EMR systems and insurance portals Strong communication skills, both written and verbal Excellent attention to detail and organizational abilities Ability to multitask in a fast-paced environment Customer service orientation with patience for working with children and families Proficient with Microsoft 365 products Familiarity with healthcare billing processes, especially in a pediatric or therapy setting . Other Preferred Qualifications Experience in pediatric healthcare setting Knowledge of occupational therapy, physical therapy, and speech-language pathology services Familiarity with Medicaid, TRICARE, and commercial insurance plans Experience with appeals processes Bilingual capabilities (Spanish preferred)

Key Competencies Problem-solving :

Ability to navigate complex insurance requirements and resolve authorization issues

Communication :

Professional interaction with insurance representatives, healthcare providers, and families Time management : Efficiently manage multiple authorizations while maintaining patient service standards

Adaptability :

Stay current with changing insurance requirements and clinic procedures

Teamwork :

Collaborate effectively with therapists, billing staff, and management Physical Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit for extended periods and work at a computer. The employee must occasionally lift and/or move up to 15 pounds. The employee is also required to communicate clearly in person and over the phone and must maintain sufficient visual acuity to perform detailed computer tasks and review documents. Working Environment While performing the duties of this job, the employee will be exposed to indoor conditions. The noise level in the work environment is usually moderate.

Job Type:

Full-time Benefits:

401(k) 401(k) matching Dental insurance Disability insurance Health insurance Health savings account Paid time off Retirement plan Vision insurance

Work Location:

In person