PRECERTIFICATION SPECIALIST
Mercy Health Corporation | |
vision insurance, paid time off, retirement plan | |
United States, Wisconsin, Janesville | |
Jan 06, 2025 | |
Overview
Verification/certification of patient care services to ensure financial reimbursement. Responsible for insurance benefit verification and provision of clinical information for pre-certification for surgeries and other procedures and services as required by insurance companies. Interpret medical record documentation for patient history, diagnosis, and treatment options to facilitate authorizations. Communicates effectively and professionally with many stakeholders. Complete necessary forms for insurance companies and initiates appropriate follow-up. Process patient referrals to other specialties, both within Mercy Health System and to outside providers, if necessary. Utilizes excellent customer service by demonstrating written and oral communication skills. Documents thoroughly and according to department and health system expectations. This position requires moderate understanding of healthcare Revenue Cycle and the importance of evaluating and securing all appropriate financial resources to maximize reimbursement to the health system. This position assumes clinical and financial risk of the organization when collecting and documenting information on behalf of the patient. Performs other duties as assigned. Responsibilities Essential Duties and Responsibilities
Education and Experience High school diploma or equivalent required. Benefits Mercyhealth offers a generous total rewards package to eligible employees including, but not limited to: * Comprehensive Benefits Package: Mercyhealth offers a retirement plan with competitive matching contribution, comprehensive medical, dental, and vision insurance options, life and disability coverage, access to flexible spending plans, and a variety of other discounted voluntary benefit options. * Competitive Compensation: Mercyhealth offers market competitive rates of pay and participates in various shift differential and special pay incentive programs. * Paid Time Off: Mercyhealth offers a generous paid time off plan, which increases with milestone anniversaries, to allow employees the opportunity for a great work-life balance. * Career Advancement: Mercyhealth offers a number of educational assistance programs and career ladders to support employees in their educational journey and advancement within Mercyhealth. * Employee Wellbeing: Mercyhealth has a focus on wellbeing for employees across the organization and offers a number of tools and resources, such as an employer-sponsored health risk assessment and a Wellbeing mobile application, to assist employees on their wellbeing journey. * Additional Benefits: Mercyhealth employees have access to our internal and external employee assistance programs, employee-only discount packages, paid parental and caregiver leaves, on-demand pay, special payment programs for patient services, and financial education to help with retirement planning. |