Referral and Insurance Specialist - In Motion Physical Therapy - Town Center

Bon Secours

About Us

As a faith-based and patient-focused organization, Bon Secours exists to enhance the health and well-being of all people in mind, body and spirit through exceptional patient care. Success in this goal requires a culture of compassion, collaboration, excellence and respect. Mercy Health seeks people that are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive.

Referral & Insurance Specialist– In Motion Physical Therapy - Town Center

Job Summary:

The Referral and Insurance Specialist obtains authorizations from insurance companies for referrals to physicians and/or procedures/testing. Verifies eligibility/coverage for referral via phone/fax/Internet. Schedule appointments for testing at medical facilities or appointments with physicians. Gathers charge information and enter all pertinent charge and patient demographic information into computer billing system. Post all payments and make daily deposits. Assist patients regarding billing questions and account balance resolution. Promotes a positive and helpful climate for good interpersonal and interdepartmental relationships.

Essential Functions: 

• Responsible for confirming and satisfying all authorization billing requirements for therapy services by obtaining appropriate precertification/authorization from all necessary payers to avoid delays in patient treatment and prevent claims denials for missing/invalid pre-certification/authorization.
• Duties include monitoring assigned Authorization/Referral work queues. understanding payor guidelines for authorization/referral policies, timely submission, tracking and documentation of all precertification/authorizations required for upcoming services, based on therapy plan of care.
• Screens and analyzes patient medical records, in EMR system, for required provider documentation to to ensure medical necessity requirements are met in accordance with payor guidelines and any other contractual authorization entity. 
• Responsible for the timely submission, tracking and documentation of all precertification/authorizations required for upcoming services, based on outlined therapy plan of care.
• Maintain current understanding of payor guidelines for authorization/referral policies.
• Maintains confidentiality when working with patient accounts, protected health information, and release of records. Complies with HIPPA guidelines to protect patient data privacy.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Education:

High School Diploma or GED (required)

Licensure/Certification:

None

Experience:

2-3 years of experience in a related medical field with experience in processing referrals (preferred)

As a Bon Secours associate, you're part of a Mission that matters. We support your well-being—personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.

What we offer

• Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
• Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts
• Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders
• Tuition assistance, professional development and continuing education support

Benefits may vary based on the market and employment status.

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Bon secours – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com