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.
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**This full-time outpatient developmental physical therapist position will be floating between all regional locations (New Berlin, Mequon, Kenosha, Delafield, Bluemound, Center for Child Development, and Milwaukee Campus) to provide planned PT leave coverages.
Provides direct patient care in Physical Therapy and performs other related duties to assure smooth, coordinated running of the department within the pediatric Outpatient 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.
• 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.

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

• This role will include an 8 hour day every Saturday (8-4pm) at our Mequon clinic, and will float to cover anticipated PT outages at different clinic sites for the remaining 32 hours weekly.
• This is a pediatric outpatient physical therapy clinic so the candidate should be able to work with children ages birth through 18 years old who have a primary and secondary diagnoses of, but not limited to: pediatric neurodevelopmental diagnoses, TBI, torticollis, postural control, prematurity of birth, muscular dystrophy, autism, ADHD, poor motor skills, gait concerns, toe-walking, genetic disorders affecting development, and simple orthopedic conditions.

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