Washington University is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity or expression, national origin, genetic information, disability, or protected veteran status.
This position is full-time and works approximately 40 hours per week. The schedule for this position will be finalized upon hire, however, the work week is Monday through Friday during normal business hours and the position will require flexibility to meet the needs of patients and the clinical practice.
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.
PRIMARY DUTIES AND 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 as required.
Verification of ICD-10 diagnosis application with review of Epic database for follow-up visits. Collects data for internal/external requests. Stay abreast of coding changes. Attend applicable meetings and report 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. Review, follow-up, and reconciliation of pre-arrival, patient, and financial work queues as transpired.
Provides support to patient/office and pre-arrival processes when required.
Other duties as assisgned.
High school diploma with 3 years of experience in billing systems and third-party claims and/or experience in a medical office setting or related customer service/office experience.
Basic Life Support certification (Online BLS certifications, those without a skills assessment component, are not sufficient to meet the BLS requirements).
Working knowledge of clinical practice.
Coding and insurance experience.
Experience interacting with managed care plans, insurance companies, and third party payers.
Experience in ICD-10 and CPT codes.
Knowledge of medical terminology.
Ability to work independently with strong attention to detail.
Must possess good organizational and critical thinking skills with the ability to solve simple and complex problems and handle stressful situations.
Ability to prioritize multiple tasks, handle busy phones, and be capable of working in a fast-paced environment.
Excellent and professional verbal, written, and interpersonal communication skills with the ability to work well with all personnel.
Proficient computer skills to include working knowledge of Microsoft Office Suite, Internet, Epic HER, and E-mail.
Ability to handle patient medical record, billing information, and all confidential matters and information discretely.
Department Name/Job Location:
This position is with the Program in Physical Therapy located on the Medical School Campus.
The hiring range for this position is $15.85 - $19.43 per hour.
Please attach a copy of your most current signed performance evaluation (completed within the last 18 months) to your online account. If you have not received a performance evaluation, you may provide two current signed letters of recommendation (written within the last 18 months), preferably to include one letter from either a current or recent former supervisor. To attach these documents, go to: My Career Tools, Add Attachment, Attachment Type – Performance Reviews or Letters of Recommendation.
All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. Current employees applying for a new position within the university may be subject to this requirement. The screenings will include a criminal background check and, as applicable for the position, other background checks, drug screen, employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening.
Washington University in St. Louis, a medium-sized, independent university, is dedicated to challenging its faculty and students alike to seek new knowledge and greater understanding of an ever-changing, multicultural world. The University offers more than 90 programs and almost 1,500 courses leading to bachelor's, master's and doctoral degrees in a broad spectrum of traditional and interdisciplinary fields, with additional opportunities for minor concentrations and individualized programs. The faculty is composed of scholars, scientists, artists and members of the learned professions. They serve society by teaching; by adding to the store of human art, creativity, understanding, and wisdom; and by providing direct services, such as health care.