1.0 INTRODUCTION
1.1 The purpose of this standard procedure is to outline the duties, responsibilities,
authority, reporting relationships and measures of performance for the position of
Therapy/Billing Clerk.
2.0 BASIC FUNCTION
2.1 The basic function of the Therapy/Billing Clerk is a combination of Therapy
Coordinator and Billing Coordinator duties. To ensure timely follow up of
preauthorization and reauthorization requests and ensure billing for services is
completed timely and appropriately.
3.0 REQUIREMENTS:
3.1 Education:
Required: High School; computer literate
Preferred: Two-year technical college degree
3.2 Experience:
A minimum of 2 years experience in billing.
3.3 Skill, Knowledge and Abilities:
Possess excellent computer skills, strong interpersonal skills, speed and accuracy in
typing skills, above average organizational skills and time management skills, and
the ability to maintain confidentiality.
3.4 Physical:
80% sitting required, participate in communicating effectively with employees,
consumers, and public.
3.5 Mental:
Possess good reading, writing and spelling ability to communicate clearly and
effectively in the English language.
3.6 Working Conditions:
Office site, with minimal travel involved.
4.0 REPORTING RELATIONSHIPS
4.1 The Therapy/Billing Clerk will report directly to the Manager of Billing Services.
4.2 This is not a supervisory position.
5.0 AUTHORITY
5.1 To follow up on all appropriate data for preauthorization and reauthorization of
therapy services requests, and billing for services as assigned by the Manager of
Billing Services.
5.2 To commit company resources as directed by the Manager of Billing Services.
6.0 RESPONSIBILITIES
6.1 Adhere to and maintain all quality control standards and operations as set forth by the
Manager of Billing Services, in compliance with all applicable laws and regulations.
6.2 Submit billing information for Therapy Services, Adult Services & PPEC to
appropriate agencies for reimbursement.
6.3 Process retroactive requests and complete appeals.
6.4 Follow up with therapy prior authorization and reauthorization requests, retroactive
requests, and appeals.
6.5 Daily electronic filing/checking of therapy notes and weekly filing of adult services
billing sheets.
6.6 Weekly, check therapy billing sheet against notes filed. Request missing notes from
appropriate therapy provider.
6.7 Weekly completion of adult services attendance to prepare for billing.
6.8 Ensure a safe work environment.
6.9 Support and enforce all company policies and procedures.
6.10 Maintain open communication with the Manager of Billing Services, Therapy
Coordinator, and Billing Coordinator.
7.0 PRINCIPAL DUTIES
7.1 Interact with insurance companies, therapy providers and clients, as necessary to
ensure continuation of services.
7.2 Submit required documentation to insurance companies to obtain prior authorization.
7.3 Participate in trainings and webinars to ensure all procedures are up-to-date and
efficient. Report any inefficiencies to the Manager of Billing Services.
7.4 Compare therapists’ daily notes on clients served to billing invoices.
7.5 Communicate effectively with therapy providers.
7.6 Work with management to ensure company policy is followed.
7.7 Complete any other duties assigned by the Manager of Billing Services satisfactorily.
3.0 REQUIREMENTS:
3.1 Education:
Required: High School; computer literate
Preferred: Two-year technical college degree
3.2 Experience:
A minimum of 2 years experience in billing.
3.3 Skill, Knowledge and Abilities:
Possess excellent computer skills, strong interpersonal skills, speed and accuracy in
typing skills, above average organizational skills and time management skills, and
the ability to maintain confidentiality.
3.4 Physical:
80% sitting required, participate in communicating effectively with employees,
consumers, and public.
3.5 Mental:
Possess good reading, writing and spelling ability to communicate clearly and
effectively in the English language.
3.6 Working Conditions:
Office site, with minimal travel involved.