About this opportunity
Direct Orthopedic Care lists this Physical Therapy Authorization Specialist opportunity in addison, Texas. Review the employer’s description below for duties, qualifications and application requirements.
Job description
PT Authorization SpecialistAs the PT Authorization Specialist, I report to the Authorization Supervisor. I create a connection with DOC guests and ensure that our value of tenacious caring occurs. I do this by understanding the value of communication, a helpful hand, and the importance of relating to one's needs.Lead Outcomes:I lead efforts in obtaining authorization and benefit verification for new guests in the Physical Therapy service line.Ensure CPT & ICD-10 coding are supported by clinical documentation.I lead DOC customer service protocols to ensure the guest receives the required authorization for PT services performed within DOC.Manage workflow of the assigned accounts and prioritize issues to meet deadlines for authorization.I maintain guest confidentiality and ensure PHI is secure at all times. I maintain a comprehensive knowledge and working understanding of HIPAA regulations and continual compliance.Meet monthly key performance indicators.Core Responsibilities:Perform benefit verification and initiate prior authorizations (when required) on new PT guests.Perform stat requests from clinic within same business day, or the following business if received after your normal working hours.Follow up on prior authorizations submitted but not received or approved, in 72 hours (dependent on payer); Work to find solutions for authorization denials.Review Providers notes to ensure all services provided are documented and adequate for authorization submission.Obtain/Maintain knowledge of PT Authorization guidelines/policies to remain in compliance with the highest standard of authorization practices.Bill PT charges for assigned clinics within 48 business hours from DOS to align with RCM department KPIs (on a back-up basis).Brings authorization denial issues to RCM Billing Manager for review.Assists with clinic correspondence tasks, as neededAssists with guest emails/RCM guest rollover calls, as needed.Responds to emails/Teams chats in a timely manner.Attending assigned clinic check-ins weekly to remain up to date on clinical happenings and to update clinics as necessary with billing information.Competencies:Familiarization and understanding of CPT & ICD-10 codesAbility to read a clinical note and extrapolate data needed for authorization approval/billing processes.Extensive knowledge of health insurance billing and processes, provider plans and payer contracts/worker's compensation are a plusMy behaviors and standards model DOC's Core Values and deliver a service experience that is unrivaled.My work shows great attention to detail.My leadership is proactive.Understanding/Experience using PM/EMR systemsI use active listening skills.My behavior is enthusiastic.I enjoy working as part of a team.I am flexible and adaptable.I am able to lift up to 50lbs.I am proficient in computer skills.
Worksite address
addison, TX, 75001, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.