Rehab Reimb Asst-Family Rehab

Performs necessary clerical tasks to expedite the initiation/continuation of outpatient billing. Participates in quality assessment and continuous quality improvement activities. Performs all job duties and responsibilities in a courteous and customer-focused manner according to the Hurley Family Standards of Behavior. Works under the direct supervision of a departmental director or designee who reviews work for conformance to established policies and procedures.

• With input from appropriate staff, completes/types patient prior authorization forms as required by various payors for initiation/continuation of services.
• Ensures timely processing of third party paperwork; e.g., Medicare/Medicaid, managed care and commercial insurance prior authorizations, worker's compensation authorizations, Hill-Burton approvals and physician referrals.
• Maintains accurate, patient-specific log of reimbursement documentation. Conveys reimbursement/billing documentation to appropriate staff members in timely manner.
• Contacts appropriate medical departments to acquire necessary information to verify financial responsibility of patients receiving outpatient services.
• Obtains third party authorization numbers as required by various insurers. Documents information in patient records according to departmental policies and standards.
• Confers with state and local agencies, third party payers, managed care providers, and internal sources to verify patient information and insurance coverage.
• Works with health information systems and therapy staff to obtain supportive clinical documentation for third party payers when requested.
• Responds to telephone and mail inquiries relating to patient billing. Acts as a liaison between patients, third party payers, physicians, therapy staff, and other Medical Center departments with regard to billing issues.
• Assists with registration of patients into computerized information system. Captures demographic, insurance, and other information to ensure accurate and timely reimbursement.
• Maintains accurate, current departmental insurance manuals including timely dissemination of third-party payer information to staff.
• Operates office equipment, including computers, typewriters, copiers, fax machines, and other information processing equipment.

• High school diploma or equivalent.
• One (1) year of experience in responsible office work, preferably with close interaction with third party payers and physicians.
• Working knowledge of medical terminology and procedures.
• Working knowledge of billing procedures and requirements.
• Demonstrated positive working relations with physicians, third party payers, medical records, and other medical center personnel.
• Ability to work independently and make decisions in accordance with established policies and procedures.
• Ability to maintain effective working relationships with supervisors, coworkers, other Medical Center, employees, vendors, and the public.