The Physical Therapist is responsible for performing medical record reviews specific to services billed related to physical therapy with adherence to all contract requirements, ISO processes and operational unit goals to ensure customer satisfaction.
How you will make an impact:
- Conducts medical review/claim review of beneficiary health records specific to therapy services in support of investigations, cases, law enforcement requests and other activities.
- Documents findings, develops, analyses and submits necessary reports to the appropriate departments in accordance with regulations and requirements.
- Codes and prices complex claims using ICD-9, HCPCS and CPT manuals and coding guidelines when necessary as it relates to therapy services.
- Researches and obtains additional data, when necessary.
- Acts as a resource for internal and external customers.
- Maintains productivity standards and ensures reviews are conducted within required timeframes.
- Requires BA/BS in physical therapy and minimum of 3 years clinical experience; or any combination of education and experience, which would provide an equivalent background.
- Current licensed physical therapist in applicable state required.