Hybrid Pre-Authorization Specialist: Streamline Approvals

Mercycare; Cedar Rapids (IA); Hybrid; USD 25.000 - 30.000; Vollzeit

Zusammenfassung

Mercy Medical Center in Cedar Rapids, IA, is seeking a Hybrid Pre Authorization Representative to support patient-centered care by ensuring timely and accurate preauthorization for tests, procedures and medications. You will review requests for medical necessity, verify benefits, and prepare documentation for insurance companies.

The role requires strong communication and multitasking abilities, familiarity with ICD-10 coding, and experience in healthcare administration.

Qualifikationen

• Knowledge of medical terminology strongly preferred.
• Experience in medical billing/healthcare administration preferred.
• Excellent interpersonal and customer service skills.
• Ability to manage multiple tasks with interruptions.

Aufgaben

• Performs pre-authorization duties requiring good knowledge of hospital programs and procedures.
• Obtains authorizations for tests, procedures and medications; reviews for medical necessity.
• Verifies patient insurance benefits and eligibility; ensures services are covered under plan.
• Prepares and submits detailed authorization requests to insurers with required documentation.
• Understands ICD-10 coding systems for local medical review policies (LMRP), NCD and pre-authorization process.
• Records all authorization requests and follow-up actions; communicates status to clinical team.

Kenntnisse

Basic computer skills

Keyboarding

Customer service

Interpersonal skills

Oral and written communication

Multitasking

Ausbildung

High School Diploma or equivalent

Associates degree or HIM certification (RHIT/RHIA) preferred

Jobbeschreibung

Mercy Medical Center in Cedar Rapids, IA, is seeking a Hybrid Pre Authorization Representative to support patient-centered care by ensuring timely and accurate preauthorization for tests, procedures and medications. You will review requests for medical necessity, verify benefits, and prepare documentation for insurance companies.

The role requires strong communication and multitasking abilities, familiarity with ICD-10 coding, and experience in healthcare administration.