Prior Authorization Specialist (Non-Exempt)
Cape Girardeau, MO 
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Posted 7 days ago
Job Description

We're a Little Different

Our mission is clear. We bring to life a healing ministry through our compassionate care and exceptional service.

At Mercy, we believe in careers that match the unique gifts of unique individuals - careers that not only make the most of your skills and talents, but also your heart. Join us and discover why Modern Healthcare Magazine named us in its "Top 100 Places to Work."

Overview:

Responsible for knowing which assistance programs, such as drug copay cards, that patients may qualify for, assisting patients in enrolling in those programs, monitoring services rendered, and billing the assistance programs for the applicable funds. This position requires a thorough understanding of claims programs for the applicable funds.

The Prior authorization representatives are responsible for understanding insurance rules and requirements for tests and different categories of tests ordered to understand how to submit a prior authorization and clinical documentation required to receive an approval.

This position requires a thorough understanding of procedures of prior authorization requests, coding, billing, rejections and denials. It requires monitoring of insurance company regulations for changes in pre-certification, documentation, or claims submission requirements. It also requires accuracy, attention to detail and the ability to communicate well with physicians, staff, patients, and insurance companies. The Prior authorization representative also serves as a resource for other staff and patients, and always performs duties in a manner consistent with Mercy Service Standards. Performs duties and responsibilities in a manner consistent with our mission, values, and Mercy Service Standards.

Qualifications:

  • Completed certificate or education of CNA, MA, LPN and/or equivalent experience or relevant education.
  • Experience: A minimum of 3 years related experience required.
  • A minimum of 1 year experience with certificate and/or 3 years minimum relevant experience with clinical role and/or prior authorizations.Certification/Registration:

We Offer Great Benefits:


Day-one comprehensive health, vision and dental coverage, PTO, tuition reimbursement and employer-matched retirement funds are just a few of the great benefits offered to eligible co-workers, including those working 32 hours or more per pay period!

We're bringing to life a healing ministry through compassionate care.


At Mercy, our supportive community will be behind you every step of your day, especially the tough ones. You will have opportunities to pioneer new models of care and transform the health care experience through advanced technology and innovative procedures. We're expanding to help our communities grow. Join us and be a part of it all.


What Makes You a Good Match for Mercy?


Compassion and professionalism go hand-in-hand with us. Having a positive outlook and a strong sense of advocacy is in perfect step with our mission and vision. We're also collaborative and unafraid to do a little extra to deliver excellent care - that's just part of our commitment. If that sounds like a good fit for you, we encourage you to apply.


EEO/AA/Minorities/Females/Disabled/Veterans

 

Job Summary
Company
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Experience
1 to 3 years
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