Medical Billing Associate, Prior Authorization - Richardson, United States - The Warren Center

The Warren Center Richardson, United States

2 weeks ago

Description

Job Description

Summary

Reporting directly to the Clinic Medical Billing Manager, the Medical Billing Associate – Prior Authorizations supports the overall mission of The Warren Center by effectively providing accurate medical benefits and preauthorization from commercial insurance and Medicaid carriers to our billing company and our clients to ensure accurate and timely billing of all claims for services rendered.

Essential Duties and Responsibilities

To perform this job successfully, an individual must be able to perform the following satisfactorily.

Client Financial Information

Ensure Third–party verifications and authorizations are accurate and processed on a daily basis for claims preparation and submission to the health plan
Verify insurance eligibility and/or Medicaid coverage and deductibles and communicate results with clients
Obtain prior approval (authorization) of all services if required by third party payer
Follow up on authorizations to obtain authorizations for additional visits upon expiration or prior approval
Maintain follow up and documentation of all physician signed evaluations as this is best practice, even if authorization is not required by insurance.

Reception Practices (backup)

Act as an authorization and appeal liaison on behalf of the organization with health plans
Ensure that all internal and external customers are treated with respect, provide knowledgeable answers, and a welcoming attitude
Answer incoming authorization status calls/emails appropriately
Intra-office and organizational communication regarding account data and claims

Education and Experience

Required: High school diploma or General Educational Development (GED) diploma
Required: 2–4 experience in medical billing with focus in prior authorizations
Preferred: Experience with ProviderSoft medical software preferred

Additional Technical Skills, Traits and Knowledge

To perform this job successfully, an individual must be able to perform each qualification satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

High energy and passion for The Warren Center's mission is essential
Professional, dependable, and proactive
Strong interpersonal and communication skills, both verbal and written
Must possess excellent time management and organizational skills
Appropriate data and word processing skills
Ability to use basic office technology equipment
Demonstrate critical thinking, creativity, problem solving and decision-making skill
Ability to read, write, perform math and accounting functions, and proof-read

Environment

The physical requirements and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions of the job.

Frequently required to use hands to finger, handle, or feel, and use keyboard as well as see, talk or hear
Occasionally required to stand and move around for work
Moderate stress level
Long periods of sitting
The noise level in the work environment is usually moderate

Equal Opportunity Employer

The Warren Center is an Equal Opportunity Employer and we believe in an inclusive culture for all. The Warren Center provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Company DescriptionAt The Warren Center, our mission is to advocate, serve and empower children and families impacted by developmental delays and disabilities.

We help children to reach their developmental goals through individualized therapy-based care and equip parents through monthly education workshops and support groups so they can be a confident advocate for their child.

1. Early Childhood Intervention (ECI): Serving over 1,000 each month, this program provides evaluations and personalized therapy sessions to children from birth to three years of age and includes occupational and physical therapy, speech and language therapy, feeding and nutrition therapy, developmental therapy, and transition assistance to additional services.

2. The Warren Center Clinic Therapy Services: This program served 163 children last fiscal year. We enroll children aged three to five, and continue to serve them as they get older. Our licensed speech-language pathologists, occupational therapist and physical therapist focus on communication, social, sensory, and motor/ coordination skills utilizing our sensory gym, outdoor therapy yard, motor room, small therapy rooms and group classroom.

3. We also help parents whose children are in a program with family education and support services which include monthly education workshops, respite care and support groups – plus guidance to other needed services and resources.

The Warren Center ECI program has a service area of 48 zip codes including Addison, Carrollton, Coppell, Farmers Branch, Garland, Irving, Lake Highlands, Lakewood, North Dallas, Park Cities, Richardson, Rowlett, Sachse, and Wylie. We have three office locations in Richardson, Garland, and Carrollton. We make referrals to any family who needs help regardless of their city of residence.

Our Clinic Therapy Services and Family Education & Support Services is open to the entire DFW Metroplex and is not dependent on location.

Company Description

At The Warren Center, our mission is to advocate, serve and empower children and families impacted by developmental delays and disabilities.\r
\r
We help children to reach their developmental goals through individualized therapy-based care and equip parents through monthly education workshops and support groups so they can be a confident advocate for their child.\r
\r
1. Early Childhood Intervention (ECI): Serving over 1,000 each month, this program provides evaluations and personalized therapy sessions to children from birth to three years of age and includes occupational and physical therapy, speech and language therapy, feeding and nutrition therapy, developmental therapy, and transition assistance to additional services.\r
\r
2. The Warren Center Clinic Therapy Services: This program served 163 children last fiscal year. We enroll children aged three to five, and continue to serve them as they get older. Our licensed speech-language pathologists, occupational therapist and physical therapist focus on communication, social, sensory, and motor/ coordination skills utilizing our sensory gym, outdoor therapy yard, motor room, small therapy rooms and group classroom.\r
\r
3. We also help parents whose children are in a program with family education and support services which include monthly education workshops, respite care and support groups – plus guidance to other needed services and resources.\r
\r
The Warren Center ECI program has a service area of 48 zip codes including Addison, Carrollton, Coppell, Farmers Branch, Garland, Irving, Lake Highlands, Lakewood, North Dallas, Park Cities, Richardson, Rowlett, Sachse, and Wylie. We have three office locations in Richardson, Garland, and Carrollton. We make referrals to any family who needs help regardless of their city of residence.\r
\r
Our Clinic Therapy Services and Family Education & Support Services is open to the entire DFW Metroplex and is not dependent on location.

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