Division: Billing
Reports To: Operations Manager
SUMMARY
We provide full-service physiotherapy care.
This position facilitates all billing to insurance companies and patients while assisting the physiotherapists and maintains relationships with contracted insurance companies and providers. Reviews patients’ accounts for accuracy in transaction and collection and communicates with the health practitioners under the supervision of the Operations Manager.
The employee will agree to be accountable for the ESSENTIAL DUTIES AND RESPONSIBILITIES, which include the following. Other duties may be assigned:
- Assist Cleaner with the preparation of treatment rooms for patients by following prescribed procedures and protocols. This involves cleaning or refreshing treatment rooms, main areas and bathroom.
- Assist in preparing patients for physical therapy treatment by welcoming, comforting, providing, and/or assisting patients into physical therapy apparel or assigned rooms.
- Provides equipment and supplies by sanitizing and delivering equipment and supplies to treatment area; positioning equipment for therapist access; assist with positioning patient on equipment.
- Maintains safe and clean working environment by complying with procedures, rules, and regulations.
- Maintains physical therapy supplies inventory by checking stock to determine inventory level; anticipating needed supplies; placing and expediting orders for supplies; verifying receipt of supplies.
- Assist with patient intake.
- Preparing hot and cold packs based on therapist instructions.
- Assist in transporting patients.
- Assist caregivers with patient’s clean up as necessary.
- Assists with maintaining provider credentialing necessary with each insurance plan.
- Corrects, edits and manages denied claims: Invalid CPT, Invalid DX, Missing Modifier, Bill another Carrier, Invalid Eligibility, Pre-Authorization/Referral, Documentation Required or Other open tasks requiring intervention.
- Reviews, generates, and uploads insurance claims to insurance companies and submits claims by paper as appropriate.
- Reviews and make corrections to rejected claims and resubmits to payers.
- Daily review of self-pay encounters to ensure the integrity of the patients’ accounts.
- Handles internal communications with management and physiotherapists related to insurance billing and collections and requests medical records from doctors as the contracted insurance plans requested.
- Corresponds with and assists vendors involved with patient accounts. Reviews and prepares check requests for patient and insurance refunds.
- Processes and posts patient payments (cash/debit cards/credit cards) accurately and promptly by following company policies, procedures, and performance goals.
- Coordinates with the Operations Manager to ensure accurate billing information flow. Updates CPT codes and ICD-10 codes, as needed, at least on an annual basis. Works with the Operations Manager to maximize revenue potential based on our unique services and providers.
- Maintains the confidentiality of the company, patient, and billing matters.
SUPERVISORY RESPONSIBILITIES
None.
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty at a high standard. The requirements listed below represent the knowledge, skill, and/or ability required.
EDUCATION and/or EXPERIENCE
High School diploma and Bachelor of Science Degree and at least 1-year work experience in a business environment, or an equivalent combination of education and experience. Medical Billing or Coding Certification and knowledge of Current Procedural Terminology (CPT), International Classification of Diseases, and Health Care Procedure Coding System (ICD-10) knowledge preferred.
Ability to type documents, including statistical/financial typing, with accuracy. Ability to perform business math calculations. Certificate in Microsoft Excel and Microsoft Word and experience using the software. Experience with Windows-based computers is required.
LANGUAGE SKILLS
Ability to read and write English fluently. Comprehend and follow instructions from management as well as third parties. Prepare short correspondence, e-mails, and memos. Ability to communicate information received from third parties to management and senior staff members. Ability to effectively present information in one-on-one and small group situations with employees of the organization.
REASONING ABILITY
Ability to apply reasonable judgment in carrying out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
CERTIFICATES, LICENSES, REGISTRATIONS
Physiotherapy Aide and Medical Billing or Medical CPT Coding Certificates are required.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to sit or be mobile. Specific vision abilities required by this job include close vision, and the ability to adjust focus.
WORK ENVIRONMENT
The work environment characteristics described here represent those an employee encounter while performing this job’s essential functions.
Confidentiality, excellent time management skills, desire to arrive at work, and return from breaks on time to ensure the smooth operation of the clinic.
The noise level in the work environment is usually low.
This is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts, or working conditions associated with this job. While this is intended to accurately reflect the current job, management reserves the right to revise the job or to require that other or different tasks be performed when circumstances change, due to the nature of this medical practice.