Insurance Authorization Specialist- Outpatient PT/OT/ST

Thank you for considering a career at Bon Secours! Insurance Authorization Specialist - Full-Time in office Virginia Beach, Outpatient PT/OT/ST Job Description Summary of Primary Function/General Purpose of Position Position acts as the central liaison between outpatient therapy and managed care payors to obtain and track required authorization for upcoming therapy services; the associate is expected to maintain current knowledge of payer authorization requirements for outpatient therapy services. This role supports timely and accurate claim submission and reimbursement by proactively submitting and tracking all new authorization request following initial therapy assessment and assisting in the reauthorization or extension process for upcoming therapy dept procedures. The associate is expected to maintain up-to-date account documentation of all payer authorization communication and up to date authorization status. Essential Job Functions Responsible for confirming and satisfying all authorization billing requirements for therapy services by obtaining appropriate precertification/authorization from all necessary payers to avoid delays in patient treatment and prevent claims denials for missing/invalid pre-certification/authorization. Duties include monitoring assigned Authorization/Referral work queues. understanding payor guidelines for authorization/referral policies, timely submission, tracking and documentation of all precertification/authorizations required for upcoming services, based on therapy plan of care. Screens and analyzes patient medical records, in EMR system, for required provider documentation to ensure medical necessity requirements are met in accordance with payor guidelines and any other contractual authorization entity. Responsible for the timely submission, tracking and documentation of all precertification/authorizations required for upcoming services, based on outlined therapy plan of care. Maintain current understanding of payor guidelines for authorization/referral policies. Authorization process for our outpatient therapy, we do not handle coding and billing. Maintains confidentiality when working with patient accounts, protected health information, and release of records. Complies with HIPPA guidelines to protect patient data privacy. Full time, Monday-Friday in office Virginia Beach Education Qualifications Required Minimum Education: High School Diploma or GED Preferred Education: 2 Year/ Associates Degree Licensing/ Certification - If registration, certification or licensure is required, include the name of the accrediting or licensing body. Licensure/Certification Required: Required to obtain CRCR within 6 months of hire Licensure/Certification Preferred: CRCR Minimum Qualifications Minimum Years and Type of Experience: Two years in a medical secretarial or patient access position preferred. Other Knowledge, Skills and Abilities Required: Ideal candidates will have experience with ICDM-CPT coding, posting charges, data entry, knowledge of medical terminology preferred but not required. Other Knowledge, Skills and Abilities Preferred: Must possess excellent organizational, verbal communication and strong interpersonal skills. Demonstrates a high level of integrity, trust and displays exceptional customer service. This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation. Bon Secours is an equal opportunity employer. Many of our opportunities reward* your hard work with: Comprehensive, affordable medical, dental and vision plans Prescription drug coverage Flexible spending accounts Life insurance w/AD&D Employer contributions to retirement savings plan when eligible Paid time off Educational Assistance And much more *Benefits offerings vary according to employment status Scheduled Weekly Hours: 40 Work Shift: Days/Nights (United States of America) Department: Physical Therapy - Raintree - Maryview All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com. Bon Secours is part of Bon Secours Mercy Health and is a not-for-profit Catholic health system sponsored by Bon Secours Ministries and founded by the Sisters of Bon Secours. With operations in Maryland, Virginia, South Carolina, Kentucky, Florida and New York, Bon Secours owns, manages, or joint ventures 20 hospitals and 27 post-acute care facilities or agencies including skilled nursing facilities, home care and hospice services, and assisted living facilities. Consistent with its commitment to alleviate human suffering, Bon Secours has developed more than 800 affordable housing units for low income families. Bon Secours has more than 24,000 employees and has been recognized as a Gallup Great Workplace for six consecutive years. The Mission of Bon Secours is to bring compassion to health care and to be Good Help to Those in Need, especially those who are poor and dying. For more information, visit www.BonSecours.com.