Eligibility & Authorization Specialist - SimplePractice

This is a remote position.

Job Summary

RCM Staff BPO is hiring a part-time Eligibility and Prior Authorization Specialist to support a physical therapy practice.

The specialist will verify insurance eligibility and benefits, obtain prior authorizations, document payer requirements, and help ensure patients are cleared before scheduled services. This role requires strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans.

Key Responsibilities

• Verify patient insurance eligibility and benefits
  

• Confirm physical therapy coverage, copays, coinsurance, deductibles, visit limits, and exclusions
  

• Determine whether prior authorization or referral is required
  

• Submit and follow up on prior authorization requests
  

• Track authorization status, approved visits, effective dates, and expiration dates
  

• Communicate authorization issues and missing information to the practice
  

• Document verification and authorization details accurately in the EHR
  

• Contact insurance companies through phone calls and payer portals
  

• Maintain organized records and follow-up schedules
  

• Protect patient information and follow HIPAA requirements
  

Requirements

Qualifications

• At least 2 years of experience with U.S. healthcare insurance
  

• Experience with eligibility verification and prior authorizations
  

• Familiarity with commercial insurance and government health plans
  

• Experience using payer portals and insurance websites
  

• Strong written and spoken English
  

• Excellent attention to detail and follow-up skills
  

• Ability to work independently and manage multiple patient accounts
  

• Reliable internet connection and a suitable remote workspace
  

Preferred Qualifications

• Experience supporting physical therapy, rehabilitation, or pediatric practices
  

• Experience using SimplePractice
  

• Familiarity with Oregon insurance plans
  

• Experience verifying therapy benefits and visit limitations
  

Schedule

• Part-time position
  

• Must be available during Pacific Time business hours
  

• Final schedule will be determined based on practice needs
  

Work Arrangement

• Remote
  

• Philippines-based applicants preferred