CRD AMBULATORY REHAB SVCS

Overview

Coordinator Ambulatory Rehab Services, Therapy Center West

Full Time, 80 Hours Per Pay Period, Day Shift

Parkwest Overview:

Parkwest is West Knoxville’s premier medical facility and a top performing heart hospital. In addition to providing the area’s leading cardiac services, Parkwest has been nationally recognized for award-winning care throughout our facility. For 2020-21 Parkwest received recognition from U.S. News & World Report as one of the “Top 10” hospitals in Tennessee.

Therapy CTR West:

Covenant Health Therapy Center – West Knoxville is an outpatient department of Parkwest Medical Center. 

It is located at 200 Fort Sanders West Blvd, Knoxville TN.  Our hours of operation are Monday-Friday 7:00 a.m. to 6:30 p.m.

Therapy includes:  Physical Therapy, Occupational Therapy, and Speech Language Pathology. We offer assessment and treatment for patients such as:  Orthopedics (spinal and extremity), Neurological diagnoses (stroke, spinal cord injury, traumatic brain injury, etc.), Post Surgical patients, etc. This fast paced, high energy clinic requires teamwork and multitasking.  Our staff have the opportunity to work in a rewarding, supportive atmosphere while positively impacting patients’ lives.   

Position Summary:

Under general direction, serves as resource/resident expert in insurance regulations, admissions/ registration, denials, follow-up and collections for Ambulatory Rehab Services (satellite therapy clinics, cardiopulmonary rehab clinics, diabetes center and outreach and wound care center).  Performs quality control initiatives based on identified trends.  Establishes and implements corrective plan of action and process changes resulting from quality control audits.  Assists ambulatory rehab services in pursuing funding options essential for meeting the patients’ needs.

Recruiter: Jason Shubert || jshuber1@covhlth.com || 865-374-5393

Responsibilities

• Keeps abreast of insurance changes in procedures and communicate to managers. Research claims/billing regulations for interpretation and integration into policy.
• Performs follow-up on all denials and appeals. Formulates and communicates trends based on EOB, denials, etc.
• Daily maintenance of delayed claims database and multiple reports pertaining to patient accounts (e.g. Discharge/Readmit report, Failed Bill report, Miscellaneous Insurance report, etc.) for the ambulatory rehab departments.
• Generates and communicates monthly reports on payer mix, collections, and denials to managers.
• Performs quality control initiatives based on identified trends. Establishes and implements corrective plan of action and process changes resulting from quality control audits.
• Serves as liaison between ambulatory rehab services and medical records, business office, appeals, registration, and admissions. Attends related meetings and participates in process improvement.
• Assists in obtaining pre-authorization for rehab services.
• Serves as insurance liaison for external case managers, adjusters, attorneys, etc. through a patient’s tenure in the outpatient program. Investigates alternative funding options and makes recommendations to clinic managers (i.e. appeals, extension of approval, etc.) in order to meet patients’ needs.
• Provides formal/informal in-services to staff as needed. Independently makes decisions related to changes in insurance/admission/reimbursement processes.
• Holds regular meetings with all admissions/registration/clerical staff in the Ambulatory Rehab Services department. Insures flow of information for team to be effective and for consistency among departments.
• Trains all new admission, registration, and clerical staff in the Ambulatory Rehab Services departments.
• Negotiates rates for services within established guidelines to secure payment of the needed services. Collaborates with the outpatient rehabilitation case manager when other disciplines are involved.
• Informs primary therapist of insurance coverage limitations and other relevant information.
• Provides updates on patient progress to the external case manager or payer by fax, phone, or mail for continued stay approval.
• Markets Fort Sanders Therapy Centers & Patricia Neal Outpatient services to external contacts.
• Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested.
• Perform other duties as assigned or requested.

Qualifications

Minimum Education:          

Non specified; will accept any combination of formal education and/or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job, typically such as would be equivalent to a high school diploma or GED.  Preference may be given to individuals possessing a Bachelor’s degree in a directly-related field from an accredited college or university.

Minimum Experience:         

None

Licensure Requirement:      

None