Description
We looking for an experienced Billing & Insurance Authorization Specialist to join our busy pediatric therapy practice. The billing specialist will be responsible for a variety of tasks within the revenue and claim cycle to improve the revenue of the practice. Applicant must have experience utilizing Electronic Medical Records/Practice Management software.
Who are we: Tender Touch Therapy is a woman-owned and therapist owned company that provides high quality pediatric physical, occupational, and speech language therapy services. As a comprehensive team, we implement creative and effective treatment strategies in order to maximize functional independence and achieve patient-specific goals. We will advocate on behalf of each child and their family to enhance well-being and improve lifelong wellness.
Purpose: Empowering children to change their world one ability at a time.
Location: Mount Pleasant, WI
Status: Temporary position, Full Time and/or Part Time
Hours: Flexible; Monday-Friday, 7:30am-6pm.
SUB-PRODUCTS:
- Run Daily eligibility checks for all patients
- Insurance verifications for all new and existing patients with changes in insurance
- Patient finances and insurance coverages are communicated and planned for accordingly
- Deductible program plan is planned and well communicated with families
- Adding patient flags to patient accounts to reflect payment needs
- Appropriate notes are kept in the communication logs as well as upcoming appointments in regards to family communications.
- Communicate patient services needs to the rehab director
- Complete insurance authorizations and record appropriately in EMR
- Providing insurance information and being a resource for families with regard to their benefits or insurance plan.
- Discuss insurance benefits with families and educate them accordingly about payment plans and co-pays
- Discuss cash based programming with families as needed
- Keep therapists updated on insurance changes, authorization changes and authorization needs
- Submit authorization requests in a timely manner
- PA tracking and communication with therapists as needed
- Bi-weekly auth report disseminated to departments
- Pending auth report reviewed and processed weekly
- Routing authorization approval forms to FD and treating therapist
- Evaluation tracking by week for purposes of insurance authorization needs and follow up for scheduling
- Maximize authorization utilization
- Run and upload weekly cancel report
- Run and upload Last Seen report to department leads
- Contact therapists regarding insurance/scheduling questions
- Notify treating therapists and billing about a change in insurance
- Run End of Day report and distribute to staff
STATISTICS:
- New patients which are informed of insurance benefits and sign the “patient responsibility disclaimer”
- Percentage of authorization utilization for each child/discipline
- Cancellation and Show rate of full clinic (considering the procedures of the FD as well as clinic procedures)
- Scheduled evaluations that show versus NS their appointment
- Scheduled and attend evaluations for the clinic
- Hold versus active patients?
- Visits seen per month
- Percent of arrival
SUB-STATISTICS:
- Monthly dropouts as a result of insurance coverage
- Advanced scheduling of visits
- Percent of Arrival
- Friends and family referral
- Internal referrals
- Progress in the GDP (Growth Development Plan)
- Weekly advanced scheduling
- Positive parent questionnaire
- Call back referrals
