• Job Description

  Req#: 136055

  Job Details

  Position Type: Full Time

  Salary Range: $19.00 - $21.00

  Job Shift: Day

  Job Category: Health Care

  Description

  The Precertification Specialist Tier 2 job is to ensure physical therapy patient insurances are accurately verified, specifically, for therapy services prior to evaluations or the receipt of splints.

  This position is a full-time position and will be remote.

  Elite Sports Medicine + Orthopedics offers a competitive compensation package for full-time members including: Three Medical Plans Options (your choice of a PPO or HDHP), Dental and Vision Coverage, Health Savings Account (with HDHP), Employee Assistance Program, Company Provided Basic Life, AD&D and Long-Term Disability, Voluntary Life and Short-Term Disability, PTO Accrual, Paid Holidays, and 401(k) + employer match.

  MINIMUM ESSENTIAL JOB REQUIREMENTS

  • Review appointments and or surgery schedule once week ahead of time to determine which patients need referral authorization for upcoming visits
  • Obtain referral authorizations either by using online applications or by contacting each patients insurance company
  • Maintain organized working files of all referral authorizations and enter authorization numbers into the system when applicable.
  • Document all discussions with insurance companies and patients
  • Coordinate with patient all financial responsibilities and facilitate reschedule when needed
  • If Durable Medical Equipment (DME) is ordered, obtain authorization number or refer patient to a preferred provider as dictated by insurance plan
  • Obtain referral numbers to follow-up visits if necessary, for HMO established patients
  • Verify all insurances related to physical therapy and occupational therapy services
  • Ensure the appropriate Front Desk Specialist receive the insurance verification forms in a timely manner
  • Ensure all visits are authorized and the request for more visits are made in a timely manner

  
  

  KNOWLEDGE, SKILL AND COMPETENCY REQUIREMENTS

  • High school diploma required
  • College education or trade school preferred
  • Knowledge of medical practice procedures and terminology preferred
  • Experience working in a physician office or hospital billing positions preferred
  • Proven record of discussing financial responsibilities and establishing payment plans as necessary
  • Knowledge of billing and collections procedures
  • Knowledge of CPT and ICD-100-CM coding
  • Knowledge of commercial insurance, Medicare, and Medicaid reimbursement
  • Proven understanding of Explanation of Benefits forms, claim forms and insurance billing process
  • Comfortable using email and interacting in various applications
  • Orthopedic claims experience is preferred
  • Knowledge of MS Office Suite including MS Word, MS Excel, and MS Outlook
  • Excellent written and verbal communication abilities
  • Strong attention to detail and goal oriented

  We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, sexual orientation, age, disability, gender identity, marital or veteran status, or any other protected class.

• About the company

  Trusted Orthopedics serving Midtown Nashville, TN. Visit our website to book an appointment online: Elite Sports Medicine + Orthopedics

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