Insurance Billing/Collections Assistant II (Pre-Arrival Team) - Program in Physical Therapy (Remote)

Position Summary

This position works to complete insurance verification, examination and tracking of insurance authorizations, and validation of referral record accuracy. Enters demographic and insurance/referral information into necessary portions of the patient medical record. Performs varied professional services to ensure therapy services are reviewed and completed in an efficient manner. Ensures maximum reimbursement with all payers by securing necessary authorizations, completes insurance verifications, and updates Epic EMR database. Performs specialized duties with minimal supervision. Copying and faxing medical records as required.

This position is remote, however, travel to on-site business location(s) is expected, as needed, for trainings and meetings.

Job Description

Primary Duties & Responsibilities:

• Contacts necessary insurance companies for benefit verification and pre-certification of therapy procedures; notifies coding staff for missing, or inaccurate coded services.
• Works with referring physician offices to provide updated orders.
• Verifies ICD-10 diagnosis application with review of Epic database for follow-up visits.
• Collects data for internal/external requests.
• Stays abreast of coding changes.
• Attends applicable meetings and reports results.
• Obtains insurance information from patients and reviews medical record for accuracy.
• Supplies all documentation required during pre-certification process to insurance companies.
• Maintains open communication with providers and referring physicians.
• Maintains written log of all pre-certifications in process.
• Documents and notifies necessary parties of pre-certification when received.
• Reviews, follow-ups, and reconciliation of pre-arrival, patient, and financial work queues as transpired.
• Provides support to patient/office and pre-arrival processes when required.
• Performs other duties as assigned.

Working Conditions

Job Location/Working Conditions: Normal office environment.

Physical Effort: Typically sitting at a desk or table.

Equipment: Office equipment.

Required Qualifications

Education: High school diploma or equivalent high school certification or combination of education and/or experience.

Certifications/Professional Licenses: No specific certification/professional license is required for this position.

Work Experience: Bookkeeping/Accounting And/Or Medical Collection Setting (2 Years)

Skills: Not Applicable

Driver's License: A driver's license is not required for this position.

Preferred Qualifications

Skills: Clinical Practice, Communication, Confidential Data Handling, Confidentiality, Critical Thinking, Detail-Oriented, Epic Applications, ICD Coding, Insurance, Interpersonal Communication, Managed Care, Medical Billing and Coding, Medical Terminology, Microsoft Office, Multitasking, Office Equipment, Organizing, Teamwork, Telephone System, Third Party Payers, Working Independently, Written Communication