The Director of Patient Access - Insurance Verifications & Authorizations will be charged with building and leading a regionalized verification and authorization operation for a practice of nearly 600 clinics. This leader will ensure timely, accurate insurance verification and authorization processes, reduce denials, improve revenue capture, and enhance the patient experience through efficient and compliant practices.

Essential Functions

• Leadership & Team Management:
  
  • Recruit, develop, and lead a high-performing insurance verification and authorization team.
  • Establish clear performance standards and accountability for accuracy, timeliness, and productivity.
  • Foster a culture of patient-first service, compliance, and continuous improvement.
• Operational Oversight:
  
  • Design and oversee a regionalized process for insurance verification and authorizations across the enterprise.
  • Ensure operational metrics (turnaround times, approval rates, denial reductions) are met or exceeded.
  • Implement technology solutions to streamline and automate workflows where possible.
• Patient Experience & Satisfaction:
  
  • Minimize patient financial surprises by ensuring timely and accurate insurance verification and prior authorization.
  • Partner with the Patient Access Coordination team to Improve communication with patients regarding insurance coverage and financial responsibilities.
  • Partner with the Patient Access Coordination team to drive transparency and responsiveness during the pre-service process.
• Process Improvement & Compliance:
  
  • Use data analytics to identify bottlenecks, improve turnaround times, and reduce payer denials.
  • Standardize workflows, policies, and training across all locations.
  • Ensure compliance with all payer rules, privacy regulations, and internal policies.
• Collaboration & Reporting:
  
  • Partner closely with patient access coordination, clinical operations, and IT teams to integrate verification and authorization processes into the overall patient access model.
  • Provide executive reporting on KPIs, authorization turnaround times, denial rates, and financial impacts.
  • Act as the key liaison with payers, internal stakeholders, and partner success for escalated issues.
• Strategic Planning & Development:
  
  • Develop a long-term strategy for insurance verification and authorization services to support growth and operational efficiency.
  • Identify opportunities for automation, outsourcing, or enhanced technologies.
  • Anticipate payer and regulatory changes to proactively adjust internal processes.
• Other duties and special projects as assigned
• Travel Requirement: Up to 25% travel may be required, as needed.

Required Skills & Abilities

• Proven success centralizing and scaling patient access functions.
• Strong analytical and problem-solving skills with demonstrated ability to drive metrics-based performance.
• Excellent communication, negotiation, and stakeholder management skills.
• In-depth knowledge of payer requirements, pre-certification, and regulatory compliance.

Required Credentials

• Bachelor’s degree in Healthcare Administration, Business, Finance, or related field required; Master’s preferred.
• 10+ years of progressive experience in insurance verification, authorizations, or related revenue cycle operations.
• Familiarity with Epic or other major EHR systems strongly preferred.

Expanding Access to Quality Care

At PT Solutions, we’re more than colleagues; we’re a tight-knit community united in our mission to expand access to quality care. Our commitment to you is evident in our industry-leading professional development opportunities. From ongoing evidence-based clinical education to dedicated mentorship opportunities and an APTA-accredited Orthopaedic Residency Program, we propel our clinicians toward excellence in physical therapy, occupational therapy, speech-language pathology, and athletic training.

As we aim to be the go-to rehabilitation provider, we seek committed professionals eager to join us in that mission. A career with PT Solutions is an opportunity to shape the industry and make a lasting impact. 

Let’s go further together and transform care. Join the #PTSLife today! 

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