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Physical Therapy Precertification Specialist

Elite Sports Medicine and Orthopaedic is searching for a detail-oriented, experienced Physical Therapy Precertification Specialist in the Nashville area!

Elite Sports Medicine and Orthopaedic provides the highest level of subspecialized orthopedic care and customer service. Our physicians and team are committed to excellent and integrated care, and our facilities and programming are dynamic and innovative. The Physical Therapy Precertification Specialist is responsible for ensuring all office visits and services have pre-authorization, and that patients are eligible for Physical Therapy services and physical therapy products on the date of their appointment.

EDUCATION, TRAINING AND EXPERIENCE REQUIREMENTS

  • Four-year college degree is preferred.
  • Knowledge of medical practice procedures and terminology is helpful.

PRE-CERTIFICATION RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:

Referral Authorization Duties

  • Reviews appointment and/or surgery schedule one week ahead of time to determine which patients need referral authorization for upcoming visits
  • Obtains referral authorizations either by using online applications or by contacting each patient’s insurance company
  • Maintains working file of all referral authorizations; enters authorization numbers into the computer system, when applicable. Appropriately documents all discussions with insurance companies and patients
  • Calls patient if insurance will not allow extended referral authorization—informs patient of financial obligations, or reschedules
  • Obtains authorization number for durable medical equipment or refers patient to preferred provider for durable medical equipment as dictated by insurance plan
  • Obtains referral numbers for follow-up visits for HMO established patients
  • Obtains authorization number for physical therapy or refers to appropriate facility as dictated by insurance plan

Other

  • Maintains patient confidentiality; complies with HIPAA and compliance guidelines
    established by the practice
  • Maintains detailed knowledge of practice management and other computer
    software as it relates to job functions
  • Attends continuing education courses as requested
  • Performs additional duties as requested by Manager or Team Leader/Supervisor
  • Enters approved number of visits, where applicable, in the computer system’s
    referral authorization tracking system

Benefits include Health, Dental and Vision insurance and 401k participation and match. We have high standards for Professionalism and Patient Care. We are looking for an individual with outstanding attention to detail and organizational skills to support our business of providing world-class orthopedic care. If you are committed to putting your energy and time into supporting one of the finest sports medicine and orthopedic centers in the country, submit your resume today!

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