Therapy Authorization Clerk

Job Description

Job Description

About our agency:

The Arc of South Florida Inc. is a nonprofit private agency serving the community since 1953. Our mission is to ensure the rights of all persons with intellectual and developmental disabilities through effective advocacy and to provide specialized programs and services to help clients lead meaningful and fulfilling lives. We believe in the potential of each individual's ability to live, work, learn and play in their communities. Are you looking for a job where what you do makes an impact in your community? Are you seeking a position that makes you feel good about the work you do every day and where you know you are making a difference, even behind the scenes? Working at The Arc is more than just a job - it's an opportunity to be part of something bigger! If you want to translate your talent, passion, and commitment to helping people with disabilities, families, and the community, you might be what we are looking for.

Specific Duties - Including but not limited to

1. Clerical Duties:

1. Check insurance eligibility for children receiving and needing therapy using Eligipro (daily alerts) and the Children’s Medical Services (CMS) website (at a minimum, weekly). Update and send out the eligibility list to therapists on first workday of the month.
2. Provide information to therapists about the other funding sources when appropriate: Act4Me, MDCPS, Early Steps/Part C, The Children’s Trust (TCT), CMS Safety Net, United HealthCare grant, and cash.
3. Obtain and keep up with insurance authorizations and referrals daily.
4. Review therapist logs/invoices weekly for accuracy, and to facilitate corrections, if necessary. Forward reviewed invoices and logs biweekly to main office.
5. Use Google Sheets and Excel spreadsheets to inform therapists of approaching expirations and due dates for both children with insurance and B-2 children without insurance. Updates are done on a daily or weekly basis, as appropriate, to inform therapists and service coordinator of key information.
6. Review any private pay agreements with parents, and process cash payments and receipts.
7. Process ACT4ME billing and receipts.
8. Scan and upload outside evaluations, authorizations, and all billing related documents into the EMR program.
9. Call insurance companies daily or as needed.
10. Call medical offices daily or as needed.
11. Guide parents with insurance/grant funded therapy questions and with changing to insurance with better coverage for therapies.

1. Schedule therapy team meetings for parents, as needed.
2. Create therapy classroom logs, as needed.
3. Create the FTE Therapy Schedule for B-2 children/MDCPS (Feb and Oct), if needed.
4. Create folders with copies of scripts, Individualized Family Support Plan (for B-2), educational assessments, and any outside evaluations and discharge letters, and any diagnosis letter or report (neuro, genetic) as applicable for therapists when a new child enters the program.
5. Follow up with parents regarding obtaining copies of outside evaluations and discharge letters and prescriptions when transferring therapies to the Arc
6. Write-up oral motor and therapy tools permission slips and inform administration of therapy department equipment needs, as needed.
7. Enter new student demographic data and outside evaluation date if applicable into EMR prior to initial staffing for B-2 children.
8. Assist Service Coordinators as needed with calls to parents, filing, Forms G’s.
9. Communicate effectively with parents, staff, and therapists by ensuring that any information that needs to be given to an individual includes an initial contact and a follow-up in a timely manner (e.g., email at first and then follow up with a phone call within 2-3 days).

1. Policies and Procedures

1. Follow all Agency Policies & Procedures and the Employee Handbook.
2. Comply with quality assurance expectations and standards.
3. Safety:
   1. Follow all Agency safety and security policies and procedures
   2. Report accidents, injuries and unsafe work conditions to the Site Director or assignee.
4. Ensure that personal appearance is professional and clean, following the dress code of the Children and Youth Department and wear the uniform of the program as requested.
5. Speak with others using clear and professional language.
6. Answer telephones using appropriate etiquette.
7. Maintain child/student confidentiality.
8. Maintain Agency confidentiality.
9. Protect Agency assets.

1. Interactions with families:

1. Develop and maintain positive interactions with families at all times.
2. Attend most parent/guardian education and support activities, i.e. Open House, Parents Nights.
3. Follow agency guidelines regarding technology and social media.

1. Interaction with staff

1. Develop and maintain positive working relationships with therapists and others.
2. Cooperate with co-workers and community partners.
3. Follow and provide recommendations and requests from supervisors including teachers, social workers, nurse, School Administrator and Program Director.

1. Cleaning and Organizing:

1. Maintain clean and organized work areas as required throughout the day and after the children leave using safe and effective methods.
2. Maintain organization of school by filing paperwork, storing equipment, organizing supplies, etc.
3. Maintain a hazard free environment.

1. Trainings:

1. Complete initial orientation provided by program.
2. Participate in on-going, in-service trainings.
3. Attend required trainings through contract agreements of The Arc.

1. Other:

1. Participate in fund-raising activities and agency events throughout the year.
2. Present a positive image of The Arc of South Florida to the community.
3. Attend community meetings needed for contract compliance and by Director’s directive.
4. Perform other related and additional duties as needed.

Minimum Physical Requirements & Skills:

1. Must have TB Tine test.
2. Must be able to move, lift, carry, push, pull, and place objects weighing less than or equal to 10 pounds without assistance.
3. Must be able to sit at a desk/computer for most of an 8-hour workday, occasionally getting up to handle other tasks.
4. Must be able to bend, squat, and sit on the floor.
5. Must be able to lift at least 50 pounds with assistance, if necessary.
6. Must be able to work under pressure, dealing with events that are often outside of your control, and unforeseen changes/problems.
7. Effective planning and time-management.
8. Must be able to stay alert and focused at all times to ensure the safety of ALL the children in attendance, and be ready to react in any situation.

Therapy Clerk Requirements:

1. Excellent verbal and written communication skills.
2. Minimum of High School Diploma or equivalent.
3. Proficiency in the use of Microsoft Office, especially Word and Excel.
4. Ability to work as a team player.

What we offer:

• Professional Training Opportunities
• Medical, Dental, and Vision Plans
• Paid Holidays, Vacation, Sick, and Bereavement
• Life Insurance
• Several Supplemental Insurance Policies
• Retirement Plan
• Family-friendly environment
• The Opportunity to Make a Difference in the Community and the Organization

Job Type: Full-time

COVID-19 considerations:
The Arc of South Florida, Inc. follows all DCF and CDC guidelines for COVID safety.

EEOC:

The Arc of South Florida Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Clearinghouse Education & Awareness (HB 531):

Positions requiring background screening through the Care Provider Background Screening Clearinghouse must include the Education & Awareness link: https://info.flclearinghouse.com