Physical Therapy Authorization Specialist

Administrative Sparks Glencoe, Maryland


Description

As industry-leading wound care providers, Healing Partners propel standard Skilled Nursing Facility wound care to a completely different level. Our multifaceted approach relieves various burdens – clinical, operational, financial, and practical – from busy owners, administrators, and employees, freeing each staff member to focus optimally on his or her responsibilities and improve overall facility management.

BENEFITS OF WORKING WITH HEALING PARTNERS:

  • Competitive salary/rate
  • Monday-Friday day schedule
  • Excellent schedule - no nights; no weekends; no on-call
  • Benefits: Medical, Dental, Vision, eligible on date of hire
  • Employee Assistance Program (EAP)
  • Health Savings Account (HSA)
  • Dependent Care FSA
  • 401k, Short Term/Long Term disability and life insurance
  • Tuition Reimbursement
  • Discount Programs

Physical Therapy Authorization Specialist Job Responsibilities:

This position is responsible for obtaining insurance pre-authorization prior to the rendering of Physical Therapy wound care services and maintaining clinical documentation integrity. This includes obtaining accurate demographic information, validating insurance information including eligibility, medical policy, and benefits as needed. The role will perform these duties in accordance with ICD-10 CM coding guidelines, internal coding protocols and CMS guidance. This role will support provider education and training related to wound care modalities and billing. 

Completes accurate and timely record review to ensure the integrity of documentation compliance and timely completion of referrals. Recognizes opportunities for documentation improvement using strong critical-thinking skills. Uses critical thinking and sound judgment in decision-making, while keeping quality considerations in balance with regulatory compliance.

  • Validating insurance for preauthorization of MIST Therapy.
  • Closely monitor the status of authorization and perform frequent follow-up checks with insurance
  • Collaborates with interdisciplinary teams including physical therapists, physicians, nurse practitioners, PA's, and the department managers.
  • Assist Clinical and Operations’ departments by making recommendations for further process improvements to enhance documentation and coding quality goals and outcomes.
  • Report issues regarding non-compliance to Clinical Operations for education, corrective action plan and escalation as appropriate.
  • Connecting with outside payors to establish appropriate pre-authorization processes

Physical Therapy Authorization Specialist Qualifications and Requirements:

  • Strong critical reasoning, decision-making and problem-solving skills to analyze situations.
  • Organizational skills and attention to details to handle multiple tasks, short deadlines, frequent interruptions, and shifting priorities in support of changing company objectives.
  • Effective verbal and written communication including ability to present ideas and concepts effectively to providers, management, and other members of the team.
  • Experience with physical therapy billing and authorization, preferred
  • Bachelor’s degree in healthcare related field, preferred
  • Wound Care Experience, preferred
  • Experience with Microsoft office suite of tools including Outlook, Excel, Teams.
  • Experience using digital fax.
  • Strong analytical and problem-solving skills.
  • Strong oral and written communication skills
  • Strong organization and time management skills
  • Ability to work independently
  • Ability to multi-task

Physical Requirements:

  • Ability to sit and work at computer for long periods of time.
  • Ability to communicate via telephone

Work Environment:

  • Hybrid – in office in Sparks, MD and remote from home.

Job Type: Full-time

Salary: $18.00 - $22.00 hourly

Schedule:

  • Day shift
  • Monday to Friday

Work Location: Sparks, MD – Hybrid Schedule

Healing Partners provides equal employment opportunities to all employees and applicants for employment without regard to race, color, ancestry, national origin, gender, sexual orientation, marital status, religion, age, disability, gender identity, results of genetic testing, or service in the military. Equal employment opportunity applies to all terms and conditions of employment, including hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation, and training.