Washington University is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity or expression, national origin, genetic information, disability, or protected veteran status.

This position is full-time and works approximately 40 hours per week.  The schedule for this position will be finalized upon hire, however, the work week is Monday through Friday during normal business hours and the position will require flexibility to meet the needs of patients and the clinical practice. 

POSITION SUMMARY:

This position works to ensures maximum reimbursement with all payers by completing insurance verification, examination and tracking of insurance authorizations, and validation of referral record accuracy. Enters demographic and insurance/referral information into necessary portions of the patient electronic medical record. Performs varied professional services to ensure therapy services are reviewed and completed in an efficient manner in advance of the patient visit. Performs specialized duties with minimal supervision. Electronic faxing of required information for preparation of patient visits. 

PRIMARY DUTIES AND RESPONSIBILITIES:

1. Contacts necessary insurance companies and patients for benefit verification and pre-certification of therapy procedures; notifies coding staff for missing, or inaccurate coded services.  Works with referring physician offices to provide updated orders as required.
2. Verification of ICD-10 diagnosis application with review of Epic database for follow-up visits.  Collects data for internal/external requests.  Stays abreast of coding changes.  Attends applicable meetings and reports results.
3. Obtains insurance information from patients and reviews medical record for accuracy.  Identifies and communicates outstanding patient financial responsibility balances owed.  Supplies documentation required during pre-certification process to insurance companies.
4. Maintains open communication with providers and referring physicians.  Documents and notifies necessary parties of pre-certification when received.  Review, follow-up, and reconciliation of pre-arrival, patient, and financial work queues as required.
5. Provides support to patient/office and pre-arrival processes when needed.

OTHER FUNCTIONS:

1. Maintains required skills/competencies and participates in in-services, staff programs, continuing education and cross training programs according to established standards.  Attends staff meetings, clinic meetings, and training sessions as they relate to the position.
2. Complies with OSHA, State and Federal regulatory sources/standards.
3. Participates in quality improvement activities to ensure appropriate clinical outcomes.
4. Serves as support to all clinical staff during peak times, vacations, and illnesses. 
5. Other duties as assigned.

• High school diploma or equivalent high school certification with three years of experience in billing systems and third-party claims and/or experience in a medical office setting or related customer service/office experience.
• REQUIRED LICENSURE/CERTIFICATION/REGISTRATION:  Basic Life Support certification (Online BLS certifications, those without a skills assessment component, are not sufficient to meet the BLS requirements).

• Working knowledge of clinical practice. 
• Experience interacting with insurance companies and third party payers.
• Proficient computer skills to include working knowledge of Microsoft Office Suite, Internet, E-mail, and Epic EMR.
• Experience in ICD-10 and CPT codes, Medicare and managed-care guidelines. 
• Knowledge of medical terminology.  
• Ability to work independently and within a team with strong attention to detail. 
• Ability to prioritize multiple tasks, handle busy phones, and be capable of working in a fast-paced environment.   
• Detail-oriented, accurate, and thorough.  Precise follow-up skills.  
• Excellent and professional verbal, written, and interpersonal communication skills with the ability to work well with all personnel. 
• Good organizational and critical thinking skills with the ability to solve simple and complex problems and handle stressful situations. 
• Ability to handle patient medical record, billing information, and all confidential matters and information discretely.

This position is with the Program in Physical Therapy located on the Medical School Campus.

The hiring range for this position is $15.85 - $19.43 per hour.

This position is eligible for full-time benefits.  Please click the following link to view a summary of benefits:  https://wustl.box.com/s/8wkhs25yssf0775x9d6nd6vqa7obpth7.

This position is grade C06.

Please attach a copy of your most current signed performance evaluation (completed within the last 18 months) to your online account.  If you have not received a performance evaluation, you may provide two current signed letters of recommendation (written within the last 18 months), preferably to include one letter from either a current or recent former supervisor.   To attach these documents, go to:  My Career Tools, Add Attachment, Attachment Type – Performance Reviews or Letters of Recommendation.

All external candidates receiving an offer for employment will be required to submit to pre-employment screening for this position. Current employees applying for a new position within the university may be subject to this requirement. The screenings will include a criminal background check and, as applicable for the position, other background checks, drug screen, employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. All offers are contingent upon successful completion of required screening.

• Direct Patient Care Setting
• Normal Office Environment
• Exposure to Blood-Borne Pathogens
• Requires Protective Devices
• Typically Sitting at Desk or Table
• Repetitive Wrist, Hand, or Finger Movement
• Office Equipment