Insurance Authorization Jobs in Wisconsin (NOW HIRING)

At Children's Wisconsin, we believe kids deserve the best.
Children's Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country.
We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today.
Please follow this link for a closer look at what it's like to work at Children's Wisconsin: https://www.instagram.com/lifeatcw/
This position will work 24 hours/week.
Schedule:
Thursday - 8 hours
Friday - 10 hours
Saturday - 6 hours
Job Summary
Provides direct patient care in Physical Therapy and performs other related duties to assure smooth, coordinated running of the department within the pediatric Inpatient, Outpatient, and Clinics. Identifies, diagnoses, and treats patients with a wide variety of disabilities. Participates in program planning, development and implementation. Participates in Quality Improvement. Counsels and instructs patients/families and medical professionals involved with the patient's rehabilitative needs, monitors patient progress, ensures that recommendations are followed. Maintains clinical records according to established procedures. May participate in outreach event coverage and education/mentorship of students/residents as appropriate.
Essential Functions
- Organizational Responsibilities: supports the mission and strategic objectives of the hospital; engages in activities which support teamwork and enhances the image of pediatric Physical Therapy and Children's Hospital of Wisconsin; takes responsibility to identify opportunities for improvement.
- Participates in weekend/holiday on-call coverage rotation (Inpatient units only).
- Developmental: Understands and satisfies the needs of the neonatal, pediatric, adolescent and/or adult patient in regard to their growth and development process and as pertains to physical functioning and development.
- Patient Evaluation: Provides Physical Therapy evaluations and re-evaluations. Successfully completes required competencies.
- Treatment: Provides physical therapy treatment on a continuing basis.
- Case Management: Counsels and trains parents in the area of physical therapy and trains parents to incorporate treatment goals into the home environment. Actively participates in care management meetings.
- Documentation: Maintains written records of patient status and progress. Documentation to include but not limited to evaluation and re-evaluation reports, daily treatment notes, plans of care, progress notes, discharge summaries and insurance authorizations.
- Insurance/Authorization: Maintains up to date insurance authorization/ approval to treat patients. Works collaboratively with Financial Clearance to obtain authorizations. Submits all clinical requests in a timely fashion to ensure no lapse in care. Connects with insurance reviewers as needed to obtain authorization, perform peer to peer review etc.
- Cost Containment: Maximizes use of equipment, supplies and time, participates in hospital efforts to control costs, and pursues third party reimbursement.
- Discharge Planning: Makes referrals and monitors progress, by phone, letter, fax of all children evaluated or previously enrolled in therapy.
Legacy Essential Functions
- Accountability/Productivity: Maintains and contributes to individual and department productivity to support department/ system goals. Facilitates prior authorizations for treatment.
- Program Development: Participates in needs assessment, program planning, development, implementation and evaluation. Participates in training and support of new team members.
- Professional Development: identifies annual goals for own professional growth and the means by which to achieve them; aware of and works toward the accomplishment of OT/PT goals, participates in personal and department improvement.
- Professional Development/Continuing Education: Supervises and trains students/residents. Provides in-service training to CHW staff. Lectures on topics related to physical therapy profession. Attends conferences for continuing education to keep informed of developments in the field as well as the needs of the department.
- Personal Development Goals: Takes an active role in improvement measures, suggestions and activities related to clinical areas and core competencies.
- Research: applies current research findings in practice; participates in data collection.
- Community Outreach: supports community education and outreach efforts, including event medical coverage with outreach teams. Coordinate, develop and/or staff community outreach programs.
Education:
- Master's Degree or equivalent in Physical Therapy required
Experience:
- 1+ years clinical experience in the pediatric field or sports medicine field of Physical Therapy preferred
Knowledge, Skills and Abilities
- Knowledge of the principles of neonatal, pediatric and adolescent growth and development and child/family responses to fear, illness, injury and hospitalization.
- Excellent interpersonal, oral and written skills to effectively communicate with patient, family and medical staff in a team environment.
- The ability to represent the organization and serve consumers in a professional manner and promote a positive image of the organization and its services.
Licenses and Certifications:
- BLS-Basic Life Support Healthcare Provider - American Heart Association/American Red Cross/National Safety Council required
- License PT-Physical Therapist (24) - State of Wisconsin required
Patient Care Responsibility
- Provides care appropriate to patient population and as described in applicable policies and procedures.
Required for All Jobs:
- This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that may be requested in the performance of this job.
- Employment is at-will. This document does not create an employment contract, implied or otherwise.
Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.
Certifications/Licenses:
BLS-Basic Life Support Healthcare Provider - American Heart Association/American Red Cross/National Safety Council, License PT-Physical Therapist (24) - State of Wisconsin