Patient Advocate (Financial Counselor)

Ultipro; Minneapolis (MN); Hybrid; USD 48,000 - 56,000; Full time

Benefits offered by this job

401(K) with Company Match, Profit ShAe

Generous PTO

Holiday Pay

Floating Holiday

Short & Long-Term Disability

Paid Leave

Discretionary Bonus

Job summary

MNGI Digestive Health is seeking a healthcare payer eligibility and preauthorization specialist. You will research insurance policies, identify preauthorization requirements for complex therapies, and coordinate with internal teams to ensure timely approvals.

The role requires attention to detail, multitasking, and strong communication skills. A health care setting background and proficiency with medical software are expected, with remote work options as appropriate.

Qualifications

• High school diploma or GED required.
• Associates or Bachelor’s degree preferred.
• At least two years experience in a health care or medical office setting.

Responsibilities

• Identify preauthorization or referral requirements and processes to assure compliance.
• Research and identify payment policies from applicable insurance carriers for prescribed treatments.
• Identify preauthorization requirements for infliximab infusions, iron infusions, and PillCams and complete authorizations.
• Track prior authorization process and ensure timely approvals as expected by the department.
• Document all submissions, approvals, denials, and conversations for inter-department communication.

Skills

Problem solving

Attention to detail

Multitasking

Communication

Teamwork

Typing

Education

High school diploma or GED

Associates or Bachelor’s degree preferred

Tools

Microsoft Office

NextGen EMR/Practice Management

Insurance payers

Job description

• Location: CityView, with the ability to work remotely as appropriate.
• Salary Range: Starting range $23.23 - $26.72/hour (Where an applicant may fall on the salary range will vary based on a variety of factors, including but not limited to experience & education)
• Retirement: 401(K) with Company Match, Profit Sharing
• Time Off: Generous PTO, Holiday Pay, Floating Holiday
• Disability Coverage: Short & Long-Term Disability
• Family Support:Paid Leave and Disability
• Performance Incentive: Discretionary Bonus Based On Company, Department, and Individual Goals

Key Responsibilities

Essential Functions: In order to perform this job successfully, an individual must be able to perform each essential function satisfactorily and regular attendance is required. The responsibilities listed below are representative of the primary essential functions required; additional duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Identify preauthorization or referral requirements and the corresponding processes to assure compliance.

• Research and identify payment policies from applicable insurance carriers as they relate to the specific specialty treatments, procedures, and programs prescribed to patient.
• Identify preauthorization requirements for infliximab infusions, iron infusions, and PillCams, and complete necessary authorizations or corresponding processes.
• Research and identify medical policies from applicable insurance carriers as they relate to the specific specialty treatments, procedures, and programs prescribed to patients.
• Track process of prior authorization and ensure approvals are being received in a timely manner per department expectations.
• Document all submissions, approvals and denials, and conversations with internal and external customers for inter-departmental communication purposes.
• Analyze prior authorization denials and determine and execute appropriate next steps.
• Collaborate with internal departments to identify and implement process improvements to the patient’s financial experience.
• Utilize a data driven approach to identify issues and improve process efficiency while providing ongoing reporting that validates the success of the program.
• Establish and foster relationships with vendors to allow access to programs, data, and other opportunities for collaboration.
• Any and all other duties as assigned

Education and/or Experience:

Qualification Requirements The qualifications listed below are representative of the knowledge, skills, and/or abilities required to perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• High school diploma or GED required.
• Associates or Bachelor’s degree is preferred.
• Must have at least two years experience in a health care or medical office setting.

Certifications/Licenses:None required.

Knowledge, Skills, and Abilities

Required Knowledge

• Microsoft Office applications
• NextGen (Electronic Medical Record and Practice Management system) and related software preferred
• Insurance payers preferred

Required Skills

• Problem solve, prioritization, and critical thinking
• Attention to detail and organization

Key Abilities

• Multitask
• Communicate effectively verbally and in writing
• Work independently as well as in a team environment
• Type proficiently and accurately

Physical Requirements: The physical requirements described here are representative of the physical demands required by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee may be required to walk, sit, stand, reach overhead, and bend to the floor. The employee is regularly required to talk and hear. The employee is required to use dexterity of hands and fingers to operate a computer keyboard, mouse, and other office equipment. Specific vision abilities required by this job include close vision and ability to adjust focus. The employee may be required to lift and transport items up to 10 pounds occasionally. Employees may be required to travel to other company locations due to staffing and training needs.

Working Environment: The working environment described here is representative of the setting which an employee may encounter on the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this position,the employee works in an office environment. The employee is exposed to a computer monitor daily. The employee may be required to travel by automobile and exposed to changing weather conditions while performing the duties of this position. While performing the duties of this position, the employee must be alert to conditions that may impact the safety of patients, employees and visitors.

This job description reflects management’s assignment of key responsibilities; it does not prescribe or restrict the tasks that may be assigned.

MNGI Digestive Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

It is the policy of MNGI Digestive Health to comply with all federal and state laws concerning the employment of persons with disabilities and to act in accordance with regulations and guidance issued by the Equal Employment Opportunity Commission (EEOC). Furthermore, it is the company policy not to discriminate against qualified individuals with disabilities in regard to application procedures, hiring, advancement, discharge, compensation, training or other terms, conditions and privileges of employment

MNGI’s Culture of Caring - “We are caring people caring for people”.All caregivers should reflect our core values:

• Compassion: being empathetic and considerate of the needs of our patients and caregivers
• Teamwork: Being accountable for actions, supporting each other in meeting the needs of our patients, and respecting the voice/opinions of others assuming good intent.
• Integrity: Demonstrating honesty, trustworthiness, and transparency whenever you interact with patients or each other.

Qualifications

Education

Experience

Preferred

2 years:

Health care or medical office experience

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.