Position Title:

Medical Benefit Coordinator Department:

Physical Therapy Office Reports To:

Clinical Director /

Office Manager Employment Type:

Full-time Position Summary The Medical Benefit Coordinator is responsible for managing all aspects of patient insurance benefits and authorizations within a busy physical therapy office. This role ensures patients receive timely and accurate benefit verification, authorization approvals, and assistance with appeals and denials. The coordinator will serve as a liaison between patients, therapists, insurance companies, and office staff to support efficient care delivery and maximize reimbursement. Key ResponsibilitiesPatient Benefit Verification & Education Verify patient insurance coverage, eligibility, and benefits for physical, occupational, and speech therapy services. Provide clear explanations to patients regarding their coverage, copays, deductibles, and out-of-pocket costs. Document and update benefit information in the EMR/office system. Authorizations & Pre-Certifications Obtain prior authorizations and pre-certifications from insurance carriers. Track therapy visit limits and authorization expirations to avoid gaps in patient care. Communicate with clinical staff regarding authorization status and requirements. Denials, Appeals & Claims Support Review and analyze insurance denials, working with billing staff to identify root causes. Prepare and submit appeals with appropriate clinical documentation and references. Track status of appeals and follow up with payers until resolution. Maintain records of denied and appealed claims for reporting and trend analysis. Liaison & Communication Collaborate with therapists, front office staff, and billing teams to ensure seamless patient care and reimbursement. Act as point of contact for patients with insurance questions or issues. Communicate effectively with insurance representatives to resolve coverage disputes. Administrative Support Maintain updated knowledge of insurance payer policies and regulations. Generate reports on authorizations, denials, and appeals for management review. Assist with special projects or audits as needed.

Qualifications Education:

High school diploma or equivalent required; associate's or bachelor's degree preferred.

Experience:

Minimum 2 years of experience in medical benefits, insurance verification, or medical billing (rehabilitation/therapy experience strongly preferred).

Skills:

Strong knowledge of insurance policies, authorizations, and appeals processes. Proficiency with EMR systems and Microsoft Office Suite. Excellent communication and customer service skills. Strong organizational skills and attention to detail. Ability to work independently and as part of a team. Working Conditions Full-time, Monday through Friday. Office-based environment Compensation & Benefits Competitive salary based on experience. Health, dental, and vision insurance. Paid time off, holidays, and retirement plan options. Opportunities for growth within a multi-specialty therapy organization.

Job Type:

Full-time Pay:

$20.00 - $22.00 per hour Ability to

Commute:

Freehold, NJ 07728 (Required) Ability to

Relocate:

Freehold, NJ 07728: Relocate before starting work (Required)

Work Location:

In person