Patient Service Rep - FT, Days

mercy; Wichita (KS); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Tuition support

Matched retirement plans

Job summary

Mercy Southeast – Cardiovascular Consultants Clinic in Missouri is seeking a Prior Authorization Representative. You will verify insurance benefits, manage prior authorizations, and assist with billing for applicable funds.

The role requires effective communication with physicians, staff, patients, and insurers to ensure timely approvals and compliant documentation. Location: Cape Girardeau, MO; Hours: Full-Time, 40 hours/week.

Qualifications

• Minimum 3 years related experience in a healthcare setting.
• Prior authorization experience preferred or required with clinical exposure.
• Strong accuracy, attention to detail and multi-tasking abilities.

Responsibilities

• Coordinate patient accounts, verify insurance benefits and coverage.
• Manage denials and handle prior authorization submissions.
• Communicate with physicians, staff, patients and insurers clearly.
• Ensure procedures align with Mercy service standards and policies.

Skills

Typing speed 40 wpm+

Insurance verification

Prior authorizations

Communication with stakeholders

Education

CNA

MA

LPN

Some college in Business/Finance/Accounting

Job description

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.

The Prior authorization representative also serves as a resource for other staff and patients, and always performs duties in a manner consistent with Mercy Service Standards. Performs duties and responsibilities in a manner consistent with our mission, values, and Mercy Service Standards.

Position Details:

Location: Mercy Southeast - Cardiovascular Consultants Clinic
371 S Broadview
Cape Girardeau, MO 63701

Hours/Schedule: Full-Time (40-hrs per week), Days

• Education: Some college hours in Business, Finance and/or Accounting related courses preferred. Completed certificate or education of CNA, MA, LPN and/or equivalent experience or relevant education.
• Licensure:
• Experience: A minimum of 3 years related experience required. A minimum of 1 year experience with certificate and/or 3 years minimum relevant experience with clinical role and/or prior authorizations.
• Certification/Registration:
• Other skills & knowledge: Typing speed 40wpm or higher.
  (skills, knowledge, abilities)

Why Mercy?

From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.

Join a caring, collaborative team where your voice matters. At Mercy, you'll help shape the future of healthcare through innovation, technology, and compassion. As we grow, you'll grow with us.