Therapy/Billing Clerk

1.0 INTRODUCTION

1.1 The purpose of this standard procedure is to outline the duties, responsibilities,

authority, reporting relationships and measures of performance for the position of

Therapy/Billing Clerk.

2.0 BASIC FUNCTION

2.1 The basic function of the Therapy/Billing Clerk is a combination of Therapy

Coordinator and Billing Coordinator duties. To ensure timely follow up of

preauthorization and reauthorization requests and ensure billing for services is

completed timely and appropriately.

3.0 REQUIREMENTS:

3.1 Education:

Required: High School; computer literate

Preferred: Two-year technical college degree

3.2 Experience:

A minimum of 2 years experience in billing.

3.3 Skill, Knowledge and Abilities:

Possess excellent computer skills, strong interpersonal skills, speed and accuracy in

typing skills, above average organizational skills and time management skills, and

the ability to maintain confidentiality.

3.4 Physical:

80% sitting required, participate in communicating effectively with employees,

consumers, and public.

3.5 Mental:

Possess good reading, writing and spelling ability to communicate clearly and

effectively in the English language.

3.6 Working Conditions:

Office site, with minimal travel involved.

4.0 REPORTING RELATIONSHIPS

4.1 The Therapy/Billing Clerk will report directly to the Manager of Billing Services.

4.2 This is not a supervisory position.

5.0 AUTHORITY

5.1 To follow up on all appropriate data for preauthorization and reauthorization of

therapy services requests, and billing for services as assigned by the Manager of

Billing Services.

5.2 To commit company resources as directed by the Manager of Billing Services.

6.0 RESPONSIBILITIES

6.1 Adhere to and maintain all quality control standards and operations as set forth by the

Manager of Billing Services, in compliance with all applicable laws and regulations.

6.2 Submit billing information for Therapy Services, Adult Services & PPEC to

appropriate agencies for reimbursement.

6.3 Process retroactive requests and complete appeals.

6.4 Follow up with therapy prior authorization and reauthorization requests, retroactive

requests, and appeals.

6.5 Daily electronic filing/checking of therapy notes and weekly filing of adult services

billing sheets.

6.6 Weekly, check therapy billing sheet against notes filed. Request missing notes from

appropriate therapy provider.

6.7 Weekly completion of adult services attendance to prepare for billing.

6.8 Ensure a safe work environment.

6.9 Support and enforce all company policies and procedures.

6.10 Maintain open communication with the Manager of Billing Services, Therapy

Coordinator, and Billing Coordinator.

7.0 PRINCIPAL DUTIES

7.1 Interact with insurance companies, therapy providers and clients, as necessary to

ensure continuation of services.

7.2 Submit required documentation to insurance companies to obtain prior authorization.

7.3 Participate in trainings and webinars to ensure all procedures are up-to-date and

efficient. Report any inefficiencies to the Manager of Billing Services.

7.4 Compare therapists’ daily notes on clients served to billing invoices.

7.5 Communicate effectively with therapy providers.

7.6 Work with management to ensure company policy is followed.

7.7 Complete any other duties assigned by the Manager of Billing Services satisfactorily.

3.0 REQUIREMENTS:

3.1 Education:

Required: High School; computer literate

Preferred: Two-year technical college degree

3.2 Experience:

A minimum of 2 years experience in billing.

3.3 Skill, Knowledge and Abilities:

Possess excellent computer skills, strong interpersonal skills, speed and accuracy in

typing skills, above average organizational skills and time management skills, and

the ability to maintain confidentiality.

3.4 Physical:

80% sitting required, participate in communicating effectively with employees,

consumers, and public.

3.5 Mental:

Possess good reading, writing and spelling ability to communicate clearly and

effectively in the English language.

3.6 Working Conditions:

Office site, with minimal travel involved.