Occupational Therapist EXApply
System-wide Hospital(s) and Outpatient Clinics: Customers include those with disabilities due to birth defects, trauma, illness, aging. Customer ages may include infants, pediatrics, adolescents, adults, and geriatrics. Completes required documentation including treatment authorizations, evaluations, daily/weekly notes, flow sheets, IRF-PAI elements and discharge summaries meeting organizational policies.
• Performs financial screening of patients, using applicable tools and problem-solving skills thru use of obtaining insurance authorization for therapy outpatient services.
• Communicates North Memorial’s financial policy to the patient and/or patient’s family representative regarding the specific level of insurance benefit coverage and estimated patient liability.
• Assists patients/guarantors who have questions/concerns regarding their therapy accounts.
• Works collaboratively with other disciplines (billing, coding, patient accounting, therapies) in assessing the financial needs of the patient and other possible resources for payment.
• Provides cost estimates to prospective and current patients.
• Maintains advanced working knowledge and understanding of insurance eligibility and benefits to determine principle payers and coordination of benefits for all insurance products.
• Responsible for assigned WQ’s.
• Works with department management to identify training and process improvement opportunities.
• Possesses ability to explain and handle patient therapy billing complaints with proper resolution.
• Understand outpatient documentation guidelines, requirements and policies for all disciplines.
• Understand medical policy coverage criteria for rehabilitation services for all payers.
• Educate therapy team members on insurance guidelines and changes and documentation standards.
• Understand Medicare guidelines, Medicare fee schedule, Medicare thresholds and Advance Beneficiary notices.
• Understand Current Procedural terminology (CPT) for rehabilitation services.
• Track Medicare therapy patient claims, and collaborate with team members to develop a plan when an Advance Beneficiary Notice may be required.
• Complete medical necessity chart reviews for all disciplines monthly and provide feedback to team members of process improvements.
Baccalaureate or Master's degree from an AOTA accredited school of occupational therapy.
Experience in one of the clinical areas essential - may be from fieldwork experiences
Knowledge, Skills and Abilities
• Demonstrated verbal, written and interpersonal communication skills.
• Current NBCOT certification or certification eligible
• Current BLS certification or completion of certification during orientation period
• Must possess current class D driver’s license in state of residency with an acceptable driving record if driving to alternate locations
• Must provide annual proof of insurance per hospital policy if driving to alternate locations
At North Memorial Health, we’re on a mission to change healthcare. We’re delivering unmatched customer service and empowering our customers throughout Minnesota and Western Wisconsin to achieve their best health. North Memorial Health is a leader in delivering advanced medical care from Emergency, Urgent Care, Specialty Programs and Services, Primary Clinics, Ambulance and Air Medical Transportation.