Therapies Prior Authorization and Scheduling Specialist

Description

Neuroscience Group is currently looking to add to their Therapies Prior Authorization and Scheduling Team.  We have a full time position (32-40 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

• Prior experience with EPIC.
• Possesses high level of intelligence, integrity, sense of responsibility, and ability to comprehend and analyze details.
• Exhibits emotional maturity, stability, and calm in stressful situations.
• Utilizes creativity and critical thinking in a team supported environment

KNOWLEDGE/SKILLS REQUIRED TO BE SUCCESSFUL IN THIS POSITION

• Computer knowledge and keyboarding skills
• Medical terminology
• Excellent communication skills
• Ability to consistently demonstrate, through conduct and communications, the stability required to effectively assist patients and referring providers.
• Customer service experience
• High level of interpersonal skills, as this position continually requires demonstrated poise, professionalism, tact, and diplomacy.
• Strong organizational skills
• Detail-oriented
• Ability to multi-task and work well in a fast-paced setting
• Critical thinking skills and decisive judgment

TYPICAL PHYSICAL DEMANDS AND WORKING CONDITIONS

• Primarily seated work but will require some position change including bending, stooping, and stretching.
• May involve lifting supplies up to 20 to 30 pounds.
• May occasionally need to assist with wheelchair transfers.
• Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment.
• Requires normal range of hearing and eyesight in order to communicate and function within this setting.

BENEFITS

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

• Health Insurance
• Health Savings Accounts with a generous employer contribution
• Dental Insurance
• Vision Insurance
• Company paid Long Term Disability and Life Insurance
• Voluntary Life and Short-Term Disability Insurance
• Generous PTO and Sick Banks
• 401(k) with guaranteed employer contribution, Profit Sharing, and a Cash Balance Pension Plan
• Employee Assistance Program
• Annual voluntary health risk assessments (company paid)
• Timber Rattler tickets
• Holiday party, summer picnic, and annual recognition for years of service
• Annual Employee Appreciation Day