Pre-Certification & Insurance Benefits Specialist

MHM Support Services; United States; Remote; USD 36,000 - 60,000; Full time

Job summary

Mercy is seeking a Patient Benefit Representative to manage all aspects of insurance and benefit analysis before services are provided. The role requires strong knowledge of various payors and the ability to secure authorizations and referrals as needed.

You will review appointments, determine out-of-pocket responsibilities, and mentor fellow staff while contributing to timely reimbursement and smooth patient experiences within Mercy.

Qualifications

• Understanding of insurance terminology and medical insurance plans.
• Experience with financial clearance processes and Mercy payment plan options.
• Ability to review appointments and obtain necessary authorizations.

Responsibilities

• Facilitate insurance and benefit analysis prior to service delivery.
• Review patient appointments and admissions for financial clearance.
• Coordinate with insurance companies to secure authorizations and referrals.
• Assist and mentor fellow Patient Benefit co-workers.

Job description

Mercy is seeking a Patient Benefit Representative to manage all aspects of insurance and benefit analysis before services are provided. The role requires strong knowledge of various payors and the ability to secure authorizations and referrals as needed.

You will review appointments, determine out-of-pocket responsibilities, and mentor fellow staff while contributing to timely reimbursement and smooth patient experiences within Mercy.