Overview
This position involves completing insurance verification, examination, and tracking of insurance authorizations, as well as validating referral record accuracy. The role includes entering demographic and insurance/referral information into patient medical records and performing professional services to ensure therapy services are reviewed and completed efficiently. The goal is to ensure maximum reimbursement from all payers by securing necessary authorizations, completing insurance verifications, and updating the Epic EMR database. Additional duties include copying and faxing medical records as required.
This is a remote position; however, occasional travel to on-site business locations is expected for trainings and meetings.
Responsibilities
- Contact insurance companies for benefit verification and pre-certification of therapy procedures; notify coding staff of missing or inaccurate coded services.
- Collaborate with referring physician offices to obtain updated orders.
- Verify ICD-10 diagnosis application by reviewing the Epic database for follow-up visits.
- Collect data for internal and external requests.
- Stay informed about coding changes.
- Attend relevant meetings and report outcomes.
- Obtain insurance information from patients and review medical records for accuracy.
- Provide all documentation required during the pre-certification process to insurance companies.
- Maintain open communication with providers and referring physicians.
- Keep a written log of all pre-certifications in process.
- Document and notify necessary parties when pre-certifications are received.
- Review, follow up, and reconcile pre-arrival, patient, and financial work queues.
- Support patient/office and pre-arrival processes as needed.
- Perform other duties as assigned.
Working Conditions
- Normal office environment.
- Primarily sitting at a desk or table.
- Use of standard office equipment.
Qualifications
Required
- High school diploma or equivalent certification, or a combination of education and/or experience.
- Minimum of 2 years of experience in bookkeeping/accounting and/or a medical collection setting.
Preferred
- No additional education, certifications, or work experience required beyond those stated.
Skills
- Clinical practice knowledge
- Communication skills
- Confidential data handling and confidentiality
- Critical thinking and detail orientation
- Experience with Epic applications
- ICD coding knowledge
- Understanding of insurance and managed care
- Medical billing and coding expertise
- Medical terminology familiarity
- Proficiency with Microsoft Office
- Ability to multitask and organize
- Experience with office equipment and telephone systems
- Interpersonal communication and teamwork
- Ability to work independently
- Strong written communication skills
Compensation & Benefits
- Hourly salary range: $17.34 - $25.40, based on qualifications, performance, equity, market rates, and department budget.
- Up to 22 days of vacation, 10 recognized holidays, and sick time.
- Competitive health insurance with priority appointments and lower copays/coinsurance.
- Free Metro transit U-Pass for eligible employees.
- Defined contribution (403(b)) Retirement Savings Plan with combined employee and employer contributions starting at 7%.
- Wellness programs including challenges, health screenings, mental health resources, mindfulness courses, employee assistance program (EAP), financial resources, and access to dietitians.
- Family benefits including 4 weeks of caregiver leave to bond with a new child, family care resources, and adult care support.
- Tuition coverage for employees and their families, including up to 100% for dependent undergraduate tuition at the institution and 40% elsewhere after seven years of service.
Location
Remote position with occasional travel to on-site business locations for trainings and meetings.
Additional Information
- Pre-employment screening is required, including criminal background check, drug screening, employment and education verification, physical examination, vaccinations, and governmental registry checks as applicable.
- Reasonable accommodations will be made for employees with disabilities to perform essential job functions.
- Equal employment opportunity is provided without regard to race, ethnicity, color, national origin, citizenship (where prohibited by law), age, religion, sex, sexual orientation, gender identity or expression, disability, protected veteran status, or genetic information.