Scheduling/Financial Specialist-Child Therapy

UnityPoint Health Cedar Rapids, IA
Overview

This position is PRN and only on an as needed basis, typically Monday-Friday.

POSITION SUMMARY

Under the guidance and supervision of the Lead, Supervisor of therapy business services, or Manager, the associate performs reception, billing, scheduling, charge and data entry, insurance pre-authorization, verification and benefit coordination, psychology test administration, report preparation, filing, record keeping and other duties for one or more areas within Physical Medicine and Rehabilitation. The associate is expected to acquire an understanding of, and proficiency in all functions for their assigned area. Initiative and sound judgment are required in the application of policies and procedures. In addition, this associate is expected to adhere to and exemplify the St. Luke's Standards of Excellence and the PMR associate-patient relationship policy.

Responsibilities

ESSENTIAL DUTIES AND RESPONSIBILITIES

Scheduling/receiving/greeting:

* Receives patients and visitors and answers telephone; screens calls and callers, referring them to the appropriate person.

* Creates a welcoming environment for person's served. Effectively manages positive relationships with referral sources and other members of the team. Coordinates all modifications to patient schedules, including reschedules, cancellations, no-shows and discharges. Verifies insurance eligibility and insurance coverage for Psych, Neuro-psych and therapy patients via phone or internet. Contacts patients prior to first appointment and counsels patient on coverage. If unable to contact patient prior to first appointment, counsels them when they arrive for first appointment. Documents in account notes in EPIC.

Billing/insurance/counseling:

* Manages providers calendars.

* Schedules all patient appointments.

* Gathers billing information for patients with worker's comp insurance (employer demographics, responsible billing party, billing address) and coordinates authorization for services.Coordinates Price-line requests for estimate of cost for the patient. Reconciles daily patient attendance and charges posted with revenue/usage reports. Demonstrates ability to effectively manage details by accurately completing registration/referrals, maintaining medical records, and charge correction.Monitors and completes accounts on multiple work queues in EPIC, including referrals and denials. Documents denials and billing issues to identify processes that need improvement in order to maximize efficiency and ensure proper payment within the department.

Daily and/or weekly duties:

* Problem solves, analyzes and collaborates with patient, therapist, Central Billing Office, Revenue Cycle department, and insurance companies to identify and resolve billing and denial issues, including sending appeals and trouble- shooting and correcting claim or account errors.

* Collects payment for training program participants.

* Responds to patient's questions regarding their account and ensures solutions to patient billing, complaints or concerns.

Accurate billing/collections/denials:

* Counsels patients on process for estimates of their payment for therapy, prompt pay, and financial assistance applications.

* Manages and coordinates pre-authorizations for services as needed. Sends requested documentation to third party payers for prior authorization and reauthorization of patient visits.

* Creates and modifies documents using word processing and spreadsheet computer programs.

* Maintains designated filing and record keeping systems. Assists with preparation of reports, graphs, and statistical information.

* Orders supplies for department.

* Serves as payroll timekeeper for assigned departments.Performs other related secretarial and clerical functions as requested.

Other essential duties and job responsibilities:

* Prepares test materials via computerized programs for both psychology and neuropsychology providers. Administers and scores psychological and neuropsychological tests in appropriately standardized manner under the supervision of the department psychologist and neuropsychologist.

* The associate is aware of hospital and department compliance for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or concerns regarding compliance to the immediate attention of department or hospital administrative staff.

* Purposefully conducts all aspects of the job in an ethical manner in support of the hospital's commitment to ethical behavior in all areas of personal and professional activity.

* Does not develop a social, personal or business relationship with any current or former UnityPoint Health patient with whom a therapeutic relationship was established through participation in their care or by obtaining knowledge of their medical condition.

* Successfully completes hospital-wide orientation, annual hospital competencies and department/unit specific competencies.

* For the safety of our patients and co-workers, St. Luke's Hospital requires seasonal and job related vaccinations. This is reviewed regularly during periodic health assessments.

Qualifications

PERSONAL SPECIFICATIONS

Education

* Must be at least a high school graduate

* Associate's degree preferred

Qualifications/Experience

* Writes, reads, comprehends and speaks fluent English

* Basic computer knowledge and skills

* Experience in Microsoft Word, Excel, Power Point and Outlook preferred

* Prior secretarial experience in a medical environment preferred

* Prior insurance knowledge preferred