Prior Authorization Specialist
Date Posted: Aug. 16, 2022
Reports to: Human Resources Manager
Location: MHVI – Mercy Hospital, Mercy campus (Coon Rapids, MN)
Status: 1.0 FTE (40 hours per week), 7:30am – 4:00pm or 8:00am – 4:30pm
Incumbent will be responsible for full prior authorization process for all areas of cardiology. Proactively ensure that patients do not experience unnecessary billing due to not meeting prior authorization requirements of their health insurance plan while ensuring reimbursement to the organization.
Position requires on-site training. Upon successful completion of training, remote or hybrid work may be an option. Hours will be Monday-Friday, 7:30-4:00pm or 8:00-4:30pm.
MAJOR AREAS OF ACCOUNTABILITY:
- Responsibilities include collecting all necessary documentation, contacting the provider or patient for additional information and completion of the required prior authorization to proceed with scheduling.
- Complete, timely, and accurate submission of prior authorization requests to the payors.
- Interacts with patients, insurance companies, and clinical staff, as necessary, to complete prior authorizations.
- Puts patients first. Keeps patients top of mind by completing authorizations in a timely and accurate manner.
- Stays current on prior auth requirements and methods. Shares knowledge with Business Office team.
- Is part of the prior authorization team and shares work amongst group to keep authorization moving forward in a fast paced environment.
EMPLOYMENT SELECTION CRITERIA:
- Requires high school diploma or equivalent.
- Three years of medical business office or healthcare customer service desired.
- Position requires detail orientation, self-initiation, and dependable follow-through.
- Must have strong computer skills. Epic/Excellian strongly preferred.
- Demonstrated ability in the following competencies:
|Patient Focus||Political Savvy|
|Adaptability||Communication (Written and Verbal)|
|Integrity and Trust||Interpersonal Savvy|
|Intellectual Horsepower||Problem Solving|
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.