PRE-CERTIFICATION SPECIALIST PT (PHYSICAL THERAPY)

Position Summary:

Perform insurance pre-certification to all new patients who will be seen in the PT department. Perform tasks which will allow the therapists to treat the patients based on the patient’s insurance benefits package.

Position Responsibilities/Standards:

• Attend department, clinic or company meetings as required
• Demonstrate sound judgment by taking appropriate actions regarding questionable findings or concerns
• Consistently work in a positive and cooperative manner with fellow staff members.
• Consistently demonstrate ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.
• Attend required annual in-service programs.
• Demonstrate knowledge and understanding of all company policies and procedures.
• Adheres to established facility safety requirements and procedures to ensure a safe working environment. Identifies potentially unsafe situations and notifies supervisor

Specific Duties

• Answer phones.
• Check scheduling system for new patients that will require insurance pre-certification.
• Handle personal and confidential correspondences, mail and reports.
• Request authorization as necessary for patient services.
• Maintain patient files, keeping abreast of insurance changes of recertification needs.
• Discuss out of network concerns or lack of insurance coverage with the physical therapy manager prior to notifying the patient of his or her coverage.
• Pre-certification personnel may also be called upon to assist with the completion and update of Worker Compensation forms.
• Perform confirmation phone calls to all new patients that are scheduled for the following day.
• Schedule patient appointment at the therapy front desk when the staff at the front desk is in need of assistance.
• Cross train responsibilities to those of the medical receptionist.
• Complete all authorization tasks received within 5 business days

Education/Experience Required:

• Must be a high school graduate or equivalent.
• Previous secretarial training is preferred.
• Must have excellent public relations skills.
• Must have personal computer and word processing ability.
• Previous medical office experience is preferred.

Physical Requirements:

Physical requirements for the position include the ability to frequently hear and communicate orally, see up close and at a distance, read and comprehend, stand, sit, walk, reach, handle, and/or feel objects. Maximum unassisted lift = 25 lbs. Average lift up to 10 lbs.