Therapies Prior Authorization and Scheduling Specialist

Job Description

Job Description

Description :

Neuroscience Group is growing! We have a newly created full time position (32 hours per week) available for a Therapies Prior Authorization and Scheduling Specialist. As an integral member of the Patient Access Team, Therapies Prior Authorization / Scheduling Specialist is responsible for reviewing referrals and scheduling new patient appointments for our Physical Therapy / Speech Therapy / Occupational Therapy providers. As the first point of contact for referral sources and patients, Therapy Prior Authorization / Scheduling Specialist assists referring providers and patients with navigating and understanding our therapy practice and the services that we offer.

For over thirty years, Neuroscience Group has provided excellent neurologic care for the Fox Valley and Northeast Wisconsin. Ours is the only medical facility in the area that combines neurosurgery, neurology, orthopedic spine surgery, interventional and non-interventional pain management, and physical therapy. Our practice has grown to over 50 providers and serves patients in nine outlying clinics scattered throughout the region. Our mission is to improve lives by providing the very best in brain, spine and pain care and we do that by living our company core values : personal care and compassion, teamwork, fiscal responsibility, continuous learning and improvement, initiative and leadership and community involvement.

Requirements : RESPONSIBILITIES

• Professional demeanor when handling inbound and outbound phone calls, emails, staff messages across all collaborative partners.
• Receives and sorts Epic, phone, and fax referrals from outside providers, and new patient self-referrals, in a timely manner.
• Reviews patient referral, electronic medical record, and interviews patient to determine which physical therapist service would be offered by Neuroscience Group Therapy.
• Maintains timely, complete documentation and recordkeeping to ensure accurate continuity of patient care.
• Practices exceptional scheduling acumen to manage and maximize provider service time.
• Collects and reviews all patient insurance information and submits prior-authorization request via website, phone or fax form.
• Obtains, verifies, and enters complete and accurate demographic, insurance, and medical information on all accounts.
• Determines necessity for pre-authorization and obtains authorization for physical, speech of occupational therapy services conducted in the Neuroscience Group office and outside locations.
• Upon receiving the anticipated procedure codes from the Provider, verifies insurance coverage, obtains preauthorization, and communicates with the involved parties regarding benefit eligibility and other financial issues.
• Answers incoming calls related to prior authorization using proper telephone etiquette. (AIDET)
• Ensures that ALL pertinent information is available to be submitted with auth request before submitting request (signed OV notes, PT notes, imaging, ER / PCP notes, etc)
• Notifies patients and practitioners of any services requested and / or referred that are not authorized by insurance.
• Coordinates the related documentation and communication to prepare patients for new patient appointment.
• Maintains good communication with the patient, therapists, physician, and clinical services team when needed.
• Participates in team building, process improvement, and skills enhancement training and events, as determined by Patient Access Manager.
• All other temporary and / or permanent duties as assigned by the Team Lead.
• Stays current with process, procedure and clinic changes and updates relative to role.

KNOWLEDGE / SKILLS PREFERRED TO BE SUCCESSFUL IN THIS POSITION

KNOWLEDGE / SKILLS REQUIRED TO BE SUCCESSFUL IN THIS POSITION

TYPICAL PHYSICAL DEMANDS AND WORKING CONDITIONS

BENEFITS

At Neuroscience Group we offer a very competitive salary. In addition to great pay, we also offer the following benefits :