Physical Therapy Billing Specialist VA
A billing specialist who understands outpatient rehab: timed CPT codes, the 8-minute rule, plan-of-care certifications, KX modifiers and payer visit limits. Your therapy claims go out clean, authorisations stay current and reimbursement is protected.
- Top 1% vetted talent
- No lock-in contracts
- Replacement guarantee
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Hourly rates · No lock-in contracts
Description
A Physical Therapy Billing Specialist VA manages billing for outpatient rehabilitation services, including timed CPT codes, therapy modifiers, plan-of-care requirements, authorisations and payer limits. They can submit claims, work denials, post payments and monitor therapy visits against approved allowances. Outsource Teams provides top 1% vetted talent with specialist rehabilitation billing experience, no lock-in contracts and a replacement guarantee.
Responsibilities
- Bill physical, occupational and speech therapy claims with correct timed and untimed CPT codes, units under the 8-minute rule, and GP, GO, GN, KX and CQ or CO modifiers where applicable.
- Track plan-of-care certifications and recertifications, progress notes and Medicare threshold amounts so nothing lapses.
- Verify therapy benefits, visit limits and prior authorisation requirements for each patient and monitor visits used against authorisations.
- Submit clean claims to Medicare, commercial payers and workers' compensation carriers through the clinic's billing system and clearinghouse.
- Work denials for medical necessity, missing certifications, authorisation limits and unit disputes, and file appeals with the therapist's documentation.
- Post ERA and manual payments, apply contractual adjustments and reconcile to deposits.
- Manage patient balances, copays and payment plans in line with the clinic's policy.
- Report monthly on visits billed, collections per visit, denial reasons and AR ageing for the clinic owner.
- Coordinate with therapists on documentation gaps that affect billing and provide education on billing requirements.
- Handle all patient and payment data under HIPAA.
Software & Tools
Requirements
- At least 5 years of billing experience in outpatient physical therapy, occupational therapy or multidisciplinary rehab clinics.
- Detailed knowledge of therapy billing rules including the 8-minute rule, Medicare plan-of-care requirements, KX and assistant modifiers, and MPPR.
- Proficient with rehab EMR and billing systems such as WebPT, Prompt, Raintree, Net Health or Clinicient, plus a clearinghouse such as Waystar or Availity.
- Experience billing Medicare, commercial plans, workers' compensation and personal injury cases.
- CPB or CPC certification from AAPC is a plus.
- Clear spoken and written English for payer follow-ups, patient billing questions and therapist coordination.
- HIPAA training completed.
- Reliable high-speed internet and backup power, working US clinic hours.
Frequently Asked Questions
What billing rules can they work with?
They can work with timed and untimed therapy codes, the 8-minute rule, plan-of-care requirements and relevant therapy modifiers.
Can they manage authorisations and visit limits?
Yes. They can verify benefits, monitor approved visits and track plan-of-care certifications and recertifications.
What systems can they use?
They can work with WebPT, Kareo, Cliniko, Nookal and Microsoft Excel.
How experienced are the candidates?
Candidates are expected to have at least five years of billing experience in physical therapy, occupational therapy or multidisciplinary rehabilitation clinics.
How much does it cost?
Rates are listed in USD at $7 per hour for entry-level talent, $9 per hour for intermediate and $12 per hour for senior talent. Both full-time and part-time options are available.
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