Pre-Certification Coordinator - WH

Full TIme Pre-Certification Coordinator
Mercy Women's Health Clinic

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:

The Precert-Preauth Coordinator is responsible for multiple facets of patient financial account services within the practice; including but not limited to patient benefit assessment, insurance verification, pre-certification, pre-authorizations, pre-determination for services, and referrals management. The position requires a thorough understanding of office-management software and a good working knowledge of medical/surgical clinical procedures, claims procedures and insurance company regulations. Requires accuracy, attention to detail and ability to communicate well with physicians, staff, patients and provider representatives of insurance companies.

Qualifications:

• Education: High school graduate or equivalent.
• Experience: Two year minimum experience working with healthcare insurance, billing and coding.
• Computer skills: word processing, spreadsheet (Word, Excel), EPIC. Excellent written and verbal communication skills. Knowledge of current coding for CPT/ICD-10/HCPS.
• Preferred Certifications: Certification as Coding Specialist preferred

Assesses, obtains, verifies and documents patients' insurance coverage and benefits to determine coverage for physician office visits, diagnostic testing and surgical procedures.As determined by the patient's insurance, obtains pre-certification and/or preauthorization prior to hospitalization, off-site surgery, diagnostic procedures, treatments and or physician visits.Communicates with patients their benefits and potential out of pocket exposure for surgical procedures ordered by physicians.Documents accurately in computer database all referral, pre-certification and other information relevant to a patient's insurance coverage and financial arrangements.Files with patient's insurance company and monitors response to pre-determination letters for surgical procedures.Responds promptly to requests from Mercy billing services for information, corrections and account updates.Under the direction of a manager or administrator, works together with social worker and appropriate co-workers to identify patients who require financial assistance and supports the process by which application is made and eligibility is determined.Acts as a resource to staff regarding insurance and billing processes.Responds to patient inquiries regarding insurance and billing issues and coordinates responses with Mercy billing services.Performs other duties as assigned.

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.