Key Facts

Remote From:

Full time

English

Hard Skills

ICD Coding (ICD-9/ICD-10) CPT Coding Prior Authorization Electronic Medical Record KPI Reporting Data Entry Medical Abbreviations Account Management Credential Manager Auditing +9 more

Other Skills

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Time Management
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Customer Service
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Organizational Skills
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Detail Oriented
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Prioritization
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Social Skills

Roles & Responsibilities

Typing speed of 60 words per minute preferred
Strong interpersonal, oral and written communication skills
Good organizational skills with ability to prioritize to meet deadlines
Understanding of medical reimbursement and terminology

Requirements:

Manage all aspects of the prior authorization process, including collecting documentation, contacting clients for additional information, and completing authorizations for private clinic and hospital clinics
Identify, submit, and track prior and retro authorizations to payors with timely, accurate processing; document account activity in the EMR
Interacts with clients, insurance companies, patients, and sales representatives as needed to request prior authorizations and resolve issues to ensure timely claims submission
Analyze authorization trends and issues affecting billing and reimbursement, maintain outstanding authorization accounts, and prepare daily productivity reports

PT Solutions Physical Therapy

About PT Solutions Physical Therapy

PT Solutions starts with a true love of therapy and fuses that passion with science and training to create an unmatched standard of care for patients. We love our work, and that enthusiasm is evident in all we do, both in the clinic and in the community. With acute care, inpatient rehab, and outpatient clinics across the country, we work in partnership with our patients and are committed to keeping them in motion throughout all phases of injury and healing. That dedication creates authentic connections with patients and makes PT Solutions the best place to redefine recovery. We believe that grounding treatment methodologies in evidence-based research results in the most effective, progressive care for patients. We put science first and use our research to innovate and lead the healthcare industry. Because teaching is in our DNA, we bring that research into the classroom, producing the best practitioners in the business through our top-notch residency and continuing education program. We believe physical, occupational, and speech therapy has a significant place in healthcare, and we want to lead its significance by elevating patient treatment standards and therapist training programs. Patients know the treatment they receive in any PT Solutions location nationwide will meet the absolute highest standard of care. Our dedication to working with the best tools and the best attitude to achieve the best results unites therapists and patients in a shared goal: pain-free living.

Company type: Large

Founded: 2018

Company size: 1001 - 5000

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Job description

Job Overview & Responsibilities:

The Authorization Specialist is responsible for all aspects of the prior authorization process. Responsibilities include collecting all the necessary documentation, contacting the client for additional information and completion of authorization (both private clinic and hospital clinics). Complete, timely, and accurate identification and submission of prior and retro authorization requests to the payors. Interacts with clients, insurance companies, patients, and sales representatives, as necessary, to request for prior authorizations. Responsible for documenting account activity, updating patient and claim information within assigned EMR system. Ensure all functionalities are utilized for the most efficient processing of claims and identifies prior authorization trends and/or issues resulting in delayed claims processing. Provides the highest level of customer service to internal and external clients. This position requires simple computer data entry and use of Microsoft Office Products

ESSENTIAL FUNCTIONS

Obtains necessary information to submit authorizations for new and continue of care patient needs.
Communicates and works effectively with colleagues from other departments
Become proficient in the use of ICD-10 and CPT codes
Understand Payor expectations for billing, reimbursement, credentialing, audit
Identify and report trends and prior authorization issues relating to billing and reimbursement
Reviews accounts daily while meeting or exceeding all daily, weekly, and monthly production goals
Document all account activity and correspond to inquires in a timely manner
Proactively manages and maintains all outstanding authorization accounts to increase billing of clean claims
Research patient accounts due to invalid and/or missing authorization information and correspond with clients,
insurance companies, patients, sales representatives to obtain the necessary information to ensure accurate, timely
and complete claims submission
Prepares daily productivity report and submits it to Authorization Supervisor
Performs additional duties deemed necessary to the position and its function

Qualifications & Pay Range:

DESIRED SKILLS & ABILITIES

Ability to type 60 words per minute preferred.
Strong interpersonal, oral (includes telephone skills) and written communication skills.
Good organizational skills and an ability to prioritize to meet deadlines.
Complete understanding of medical reimbursement and terminology.
Ability to work with disabled individuals.
Working knowledge of all standard office equipment.
Working Knowledge of insurance and outpatient billing procedures.
High School Diploma with courses in bookkeeping and accounting OR an equivalent amount of work experience in a healthcare or related setting

Compensation:

$18-20 hourly (Any posted pay range considers a wide range of compensation factors, including candidate background, experience, and work location, while also allowing for salary growth within the position)

Company Overview:

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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