Patient Financial Services Rep I (Therapy & Learning Center)

West Tennessee Healthcare•Greendale, WI

66d

About The Position

Responsible for the ongoing efficient, effective, and compliant operations of therapy services in the clerical, compliance (with aide and under direction of management), reimbursement, and billing portions of the business. Under the general supervision of the Billing Reimbursement Manager. Normal working hours vary, Monday through Friday, during day shift. Employee is subject to call back and overtime as required by the hospital.

Requirements

Associates Degree in billing and accounts or High School Diploma with experience.

Nice To Haves

1 - 2 years of healthcare experience preferred.

Responsibilities

Process referrals for therapy services, ensuring all necessary information is obtained.
Communicates with referral source and/or patient’s family to obtain any needed information.
Responsible for patient registration and maintenance of current, accurate demographic and payer information.
Verifies eligibility for insurance as well as coverage for therapy services, and communicates any limitations with patient/parent/guardian.
Liaison with Billing Department staff regarding insurance, billing, denials and payment issues.
Responsible for distribution of therapy records in compliance with HIPPA and FERPA standards and HIM department policies.
Provides referral information to therapy staff and/or therapy managers for school based services.
Schedules outpatient therapy appointments as directed by therapists, and communicates needed information to other team members.
Ensures all necessary documentation has been received for each patient, and scans pertinent information into patient’s medical record.
Obtains prior authorization for services as needed.
Filing of documentation as needed.
Assist with monitoring outpatient attendance and enforcement of attendance policy.
Maintain needed databases related to referrals and ongoing therapy services.
Obtain and maintain current and appropriate physician’s orders.
Ensure payer requirements are met for therapy service provision.
Maintenance of patient encounters, including discharge of encounters when needed.
Prompt and professional correspondence with referral sources, families, insurance companies, TEIS, and others.
Collaborate with TEIS on referrals, scheduling, and ongoing service provision in outpatient setting, and with school district staff for school-based services.
Assist with front desk reception duties when requested.
Works closely with department management and WTH departments to identify and resolve any issues related to referrals, service provision, and billing/payment for services.
Gathers data, summarizes and prepares reports for management, and completes special projects as assigned.
Communicates daily via the telephone or written communication with patients/families, payers, service providers, referral sources, and departments to obtain and provide all needed information to provide services and obtain payment.
Performs related responsibilities as required or directed.