Eligibility, Authorization & Credentialing Specialist – OT/PT/SLP
Wellness Works Management Partners (WWMP)
Remote | Full-Time | W-2 | Starting at $50,000/year
Florida Candidates Preferred | Tampa Bay Area Strongly Preferred
Are you an authorization/eligibility/credentialing specialist? Do you have strong work-retention, great communication, and a detail-oriented finisher?
We are looking for someone who understands what happens before the claim is billed in an outpatient Occupational Therapy, Physical Therapy, or Speech-Language Pathology practice.
Eligibility. Benefits. Authorizations. Credentialing. Follow-up.
If you have spent at least 2 years working in an outpatient OT, PT, and/or SLP organization, we especially want to hear from you.
And if that experience is in pediatric OT/PT/SLP? Five gold stars. ⭐⭐⭐⭐⭐
Wellness Works Management Partners is a national boutique practice management company supporting OT, PT, and SLP private practices across 30+ states. We are looking for an Eligibility, Authorization & Credentialing Specialist who can become an important part of the support infrastructure behind the practices we serve.
This is not a management position and is not a traditional medical billing position.
This is a hands-on specialist role for someone who enjoys getting the details right, following something all the way through, communicating proactively, and being accountable for results.
Eligibility Responsibilities include:
- Verify insurance eligibility and active coverage
- Verify benefits for OT, PT and SLP services - via PHONE
- Identify deductibles, copays, coinsurance and patient responsibility
- Identify visit limitations and benefit maximums
- Determine referral and authorization requirements
- Use payer portals and contact insurance companies directly
- Document verification information accurately
- Communicate discrepancies and potential coverage issues
- Follow through when information is incomplete or unclear
Prior Authorizations Responsibilities include:
- Obtain initial therapy authorizations
- Track approved visits, units and authorization periods
- Monitor expiration dates and remaining visits
- Initiate extensions and renewals
- Follow up on pending authorization requests
- Maintain accurate authorization documentation
- Communicate authorization status with practices and internal team members
- Identify potential problems before they result in denied claims
Direct experience with OT/PT/SLP authorization requirements is highly valued.
Provider Credentialing & Enrollment Responsibilities may include:
- CAQH maintenance and attestations
- Commercial payer enrollment
- Provider additions and demographic changes
- Individual and group enrollment
- Application tracking and payer follow-up
- Recredentialing
- Maintaining credentialing records and trackers
- Following applications from submission through effective date
- Coordinating credentialing information with clients and our billing team
Our Ideal Candidate
Our strongest candidate has:
- strong expertise in credentialing, authorizations, eligibility for OT, PT, SLP organizations
- 2+ years working directly within an outpatient OT, PT or SLP organization strongly preferred
- Pediatric OT/PT/SLP experience is an exceptional advantage
- Hands-on experience verifying insurance benefits
- Hands-on experience obtaining and tracking prior authorizations
- Credentialing and payer enrollment experience required and can build a credentialing service within our framework
- Extremely responsive - type A - impeccable follow through
- Strong computer and technology skills
- Excellent written and verbal communication
- Exceptional attention to detail
- Strong organizational and time-management skills
- The ability to manage multiple responsibilities without losing follow-through
Your actual experience matters more to us than your job title.
Before You Apply: Understand How We Work
We want to be transparent about our expectations because fit matters tremendously to us.
WWMP is a small organization of W2 employees. We don't operate like a large corporation where missed details can disappear between departments.
Reliability Is Non-Negotiable
Remote does not mean work whenever you want.
This is a full-time, five-day-per-week position with established work expectations and accountability.
We need someone our clients, leadership team and coworkers can consistently rely upon.
Strong Communication Is Part of Your Job - REQUIREMENT
If something is delayed, we communicate.
If you're confused, we ask.
If you make a mistake, we own it.
If something needs someone's attention, we don't assume they'll eventually discover it.
We value people who communicate early, clearly and professionally.
Follow-Through Matters
Starting something isn't the same as owning it.
An authorization request isn't finished because it was submitted. A credentialing application isn't finished because paperwork was sent. An eligibility issue isn't resolved because an insurance company was called once.
We expect our team members to follow responsibilities through to resolution and maintain clear documentation along the way.
Accountability & Transparency Are Cornerstones of Our Culture
We don't expect perfection.
We do expect honesty.
Reliability, communication, attention to detail, follow-through, accountability and transparency are cornerstones of how we operate.
If you make a mistake, own it and help solve it.
If you don't know something, say so and find the answer.
If you're falling behind, communicate before it becomes a problem.
That culture has helped us build a team with strong retention, and protecting that culture is important to us.
Compensation & Growth
This position typically starts around $50,000 annually.
Your starting compensation will be evaluated based on your directly relevant experience, particularly experience within OT, PT and SLP outpatient practices and your demonstrated capabilities with eligibility, authorizations and credentialing.
We believe compensation growth should be connected to the value and results you demonstrate within the organization.
People who take ownership, produce results, expand their capabilities and become increasingly valuable to our clients can create opportunities for greater responsibility and compensation growth.
We are interested in someone who wants to grow with us, not simply occupy a position.
Important: Our Benefits Structure Is Different
We want candidates to understand this before applying.
We Do NOT Offer Traditional Paid Time Off (PTO)
WWMP does not currently offer a traditional bank of paid vacation or PTO days.
Full-time employees receive the equivalent of 8 hours of additional pay as a bonus for specific designated company holidays deemed as a bonus approach.
Because we operate remotely, there may be opportunities for scheduling flexibility when requested and approved in advance, but candidates should not interpret remote work as unlimited scheduling flexibility or traditional paid time off.
Healthcare
We do not currently offer traditional employer-sponsored medical, dental or vision insurance.
Eligible employees receive a $400/month HRA contribution to assist with qualifying healthcare expenses.
Please carefully consider whether this benefits structure works for you before applying.
About Wellness Works Management Partners
WWMP is a national boutique practice management company specializing in Occupational Therapy, Physical Therapy and Speech-Language Pathology private practices.
We support practices across more than 30 states through services including:
- Revenue Cycle Management
- Medical Billing
- Fractional HR
- Practice management and business support
We're intentionally specialized.
We don't want to be everything to every healthcare organization. We want to understand the unique challenges facing OT/PT/SLP private practices exceptionally well.
Authenticity Matters More Than Checking Every Box
Please don't answer "yes" to an application question because you think that's what will get you an interview.
If you have five years of authorization experience but limited credentialing experience, tell us.
If you have worked extensively with PT but never OT or SLP, tell us.
If you maintained CAQH but didn't personally manage payer enrollment, tell us.
If your experience is outside OT/PT/SLP but you believe it's highly transferable, tell us why.
We value candidates who accurately represent their experience.
Misrepresenting credentials, certifications, employment history or professional experience will result in disqualification from consideration.
How to Apply
Please submit your résumé and complete all Indeed application questions thoroughly.
We pay close attention to the effort and detail candidates put into the application process because communication, attention to detail and follow-through are important parts of this position.
Final candidates should expect:
- In-depth interviews regarding their actual eligibility, authorization and credentialing experience
- Professional reference checks
- Employment history verification
- Background screening
No staffing/recruiting agency submissions and no phone calls regarding this position, please.
We're not trying to fill this position as quickly as possible.
We're trying to find someone we can count on, invest in and grow with for years to come.
Pay: From $50,000.00 per year
Benefits:
Application Question(s):
- Why are you currently seeking new employment? (Requirement - we want to learn more about your "why" for applying to new roles.)
- Please transparently share your work experience directly in an Occupational, Physical, and Speech Therapy Outpatient Clinic (Please don't write - see resume or highlight other specialties - transparency - own your experience and no justifications needed - let us see your authentic experience)
- Please describe prior experience and functions related to "Credentialing" - what functions in credentialing did you hold, and specialties you have credentialed, and any additional information that highlights beyond a resume. We want to hear your voice and communication approach.
- Please describe prior experience and functions related to "Authorizations" - what specialties have you managed authorizations for and any additional information that highlights beyond a resume. We want to hear your voice and communication approach.
- Please describe prior experience and functions related to "Verifying Benefits and EOBs via Phone" - what specialties have you managers VOBs for and any additional information that highlights beyond a resume. We want to hear your voice and communication approach.
- Do you have any experience building structure in "Monday.com" as a software - this is not a require but a bonus - any experience using that software - please share direct experience here.
- IMPORTANT: What are your compensation goals year 1, year 2, and year 3 of your next employment opportunity? (Please be advised - the role begins at $50k but will grow based on results, reliability, and revenue)
Experience:
- Outpatient Occupational, Physical, & Speech Therapy Work: 2 years (Preferred)
- Credentialing: 2 years (Required)
- Authorization & Eligibility: 2 years (Required)
License/Certification:
- Certified Provider Credentialing Specialist (Preferred)
- Medical Billing Certification (Preferred)
Work Location: Hybrid remote in Tampa, FL 33607
