Experienced Physical Therapy Billing and Insurance Verification Part B Outpatient End-to-end

Only Experienced Physical Therapy Billers should apply.

The person for this position possesses the following:
1) Expert at navigating insurance portals and reading verification of benefits for all insurances
2) Explaining to the patient what their benefits are and what would be their cost of services based on their VOB
3) Has experience posting PR payments and explaining patient statements
4) Is efficient with obtaining insurance authorization and understanding what kind of insurance authorization is needed (i.e. evaluation only authorized prior to authorizing additional therapy visits, or needing PCP referral submitted through insurance portal by PCP, etc.)
5) Can identify items missing in Pre-Claim and add necessary information (appropriate Modifiers, correct Rendering Provider, use billable CPT codes that don’t conflict with other CPT codes) before sending to clearing house
6) Is resourceful when handling denials by calling insurance companies and handling record requests
7) Reaches out to patients regarding their balance
8) Accurately enters insurance policies into EMR to ensure billing is not delayed

Systems used:
EMR: Heno
Clearing house: Office Ally
Insurance Portals: Availity, UHC, Novitasphere, TriWest, Medicare, Pverify (might not be familiar with Pverify but must be willing to learn)
Task management: Click to view
Efax: Consensus

The person for this job will be in charge with getting the referral from E-fax or directly from one of our partners or providers, entering the information into Click to view for insurance verification, calling patients to explain benefits, assisting with finding therapist coverage for the patient (mobile therapy or in PT clinics and Assisted Living Facilities), then transferring that information to Heno (EMR). They will handle pre-claims, posting payments for co-pays and co-insurance collected by other staff, send statements to patients monthly, call patients that have an active balance on their account to obtain payment, work closely with other Virtual Assistants to ensure accuracy and good communication.

Each referral is treated as urgent as often times the patients we serve are directly out of the hospital from a surgery and we may not get the referral until last minute.

Outcomes Therapy works as a solid team, we meet regularly, bonus regularly for good work, and we love to have FUN!

****Please only apply if you feel like you have MOST of the experience necessary to perform these job functions. We are happy to train, but a solid foundation with Physical Therapy billing for Outpatient Part B (not home health or hospital) and insurance verification is a MUST