Patient Service Rep - FT, Days

Find your calling at Mercy!

Responsible multiple facets of patient account coordination including insurance/benefit verification, denials management and coverage of services as neede and collections.

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.