Summary: The Physical and Occupational Therapy billing specialist is responsible for coordinating patient and insurance billing for our fast-growing therapy departments and providing patient care excellence by performing the following duties.

Essential Functions:

• Maintain and evaluate daily audit trails and claim rejections
• Work denials as assigned for all outpatient therapy locations
• Attempt to obtain prior authorizations if they were not obtained at the time of service
• Ability to utilize software applications to process claims, research patient accounts and billing statements.

• Responsible for following and interjecting action to facilitate the entire revenue cycle from charge entry through insurance processing and full insurance payor and patient payment in full.
• Answers telephone, and responds to inquiries from insurance carriers, patients and co-workers.
• Investigate and resolve billing discrepancies resulting in overpaid/underpaid accounts.
• Contacts patients regarding collection of outstanding balances and establishes payment/collection plans.
• Executes the actions of the OAA financial policy both internal and external as applicable.
• Establishes payment plans to help patients manage payment of bills while also managing patient access for patients with inactive accounts from non-compliance to the OAA financial policies.
• Confers with doctors, nurses, providers and other health personnel to assure complete, current, and accurate medical records.
• Retrieve messages from voicemail and execute the requests or forward to the appropriate personnel to ensure timely resolution.
• Operate a computer to process, store, and retrieve health information while following HIPPA regulations in all actions and communications.
• Other duties may be assigned.

Qualifications:

• High school diploma or general education degree (GED).
• One to two years physical/occupational therapy related billing experience; or an equivalent combination of education and experience.
• Medicare experience, preferred.
• Experience with Therapy EMR’s, WebPT preferred.
• Experience with medical practice/hospital EMRs, Athena/Epic preferred.
• Knowledge of ICD-10, CPT, HCPCS codes and documentation guidelines
• Working knowledge of third-party insurances
• Effective communication skills
• Detail oriented, outgoing, and professional.
• Ability to work independently and as part of a team
• Prior customer service representative experience beneficial

Qualifications:

• High school diploma or general education degree (GED).
• One to two years physical/occupational therapy related billing experience; or an equivalent combination of education and experience.
• Medicare experience, preferred.
• Experience with Therapy EMR’s, WebPT preferred.
• Experience with medical practice/hospital EMRs, Athena/Epic preferred.
• Knowledge of ICD-10, CPT, HCPCS codes and documentation guidelines
• Working knowledge of third-party insurances
• Effective communication skills
• Detail oriented, outgoing, and professional.
• Ability to work independently and as part of a team
• Prior customer service representative experience beneficial