Lead Patient Service Specialist- In Home Therapy
Kort Physical Therapy
Louisville, Kentucky, United States
I coordinated scheduling for two high-volume clinics, managing over 400 patients weekly and 30+ providers, while facilitating communication between physical therapists, surgery offices, case managers, hospital liaisons, and patients. I oversaw all pre-certifications and authorizations, working across platforms such as AIM, Cohere, Waystar, and Epic. I led the remodeling of the branch's pre-certification and authorization department, updating billing processes during a significant 200% growth in 2020 due to COVID-19. I performed daily audits on all active and inactive patient authorizations and pre-certifications across two clinics, ensuring that every authorization was properly secured once appointments, procedures, or treatments took place. This process included cross-referencing patient records with insurance requirements, ensuring compliance with payer guidelines, and minimizing claim denials due to authorization errors. I also conducted weekly audits focusing on billing intake disruptions. This involved reviewing all submitted claims to ensure that accurate information from the clinic was utilized, verifying that proper coding was applied, and identifying any discrepancies in the billing cycle. By auditing intake processes, I was able to identify patterns in disruptions, such as missing documentation or delays in submission, and implemented corrective measures to improve accuracy and efficiency. These audits helped reduce delays in payment and ensured that claims were processed in a timely manner, ultimately improving revenue cycle performance for the clinics. Additionally, I generated reports from these audits to highlight issues, track resolutions, and provide actionable insights to the management team, ensuring continuous improvement in the clinics' financial and operational workflows.
