Benefit Coordinator

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 with potential for hybrid/remote insurance follow-up tasks.

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