Prior Authorization/Charge Entry Specialist

Date Posted:  May 30th, 2023
Reports to:  Business Office Supervisor
Location: MHVI, Mercy Hospital campus (Coon Rapids, MN)
Job Status/Hours: Full time

Summary: We are seeking a full time, motivated and talented Prior Auth/Charge Entry Specialist to join our busy, fast paced specialty office at Metropolitan Heart & Vascular Institute. This position will be responsible for data entry of hospital charges, prior authorization for procedures and verifying accurate insurance information. Come be a part in our patient’s lives and work for an organization that puts its staff and patients first.

Responsibilities:

The essential functions include, but are not limited to the following:

  • Verify and update insurance coverage to ensure patient eligibility.
  • Act as a resource for billing, referral, and insurance questions from business office staff, employees, and patients.
  • Provide back up support for others in the business office including the business office phone daily.
  • Gather patient records and submits online requests to insurance companies for prior authorization. May need to call patient and outside facilities to gather information.
  • Is a liaison between MHVI and Allina Business office, being the patients advocate for pending or denied claims.
  • Ability to deliver high quality customer service to external and internal customers by communicating with knowledge and compassion.
  • Work as part of a team to complete departmental responsibilities.
  • Promote a positive work environment through effective teamwork.
  • Prepare and enter hospital charges.
  • Review patient work queues and corrects information when necessary.
  • Work the Claims work queue, follow-up work queue and does miscellaneous back-end follow-up.
  • Attend monthly patient services representative meetings.

Qualifications:

  • Requires high school diploma or equivalent
  • Two years of health care billing experience
  • Ability to prioritize multiple tasks with frequent interruptions
  • Deliver high quality customer service to external and internal customers
  • Ability to work efficiently and accurately in a fast pace environment
  • A team player with the ability to work independently
  • Must have strong computer skills. Epic/Excellian strongly preferred
  • Strong attention to detail and high accuracy rate required
  • Ability to develop a positive, comforting rapport with patients

MHVI offers a full benefit package, including:

– Competitive pay

– Employer HSA contribution

– 401k profit sharing and ongoing contribution – no employee contribution needed

– PTO plus paid holidays

– Medical insurance, including access to free online/at-home care

 To apply, submit your resume to HumanResources@mhvi.com

As an EEO/Affirmative Action Employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, veteran or disability status.