Easter Seals Jobs

At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence.

Primary Function/General Purpose of Position

The Insurance Authorization Specialist will work with commercial insurance carriers and pharmacies to obtain prior authorization for medications and in-office procedures and provide a high level of customer service and professionalism to patients and colleagues. The Specialist will work closely with care providers to obtain information needed to complete prior authorizations.

Essential Job Functions

• Submits prior authorization requests to insurance carriers.

• Monitors submitted requests until a determination is made by the insurance carrier, providing additional information as needed.

• Coordinates appeal process for denied requests.

• Communicates with administrative colleagues, care providers, pharmacies, and insurance carriers.

• Works proactively to identify solutions to more complex requests / inquiries when necessary.

• Complies with Health Insurance Portability and Accountability Act (HIPPA) guidelines to protect patient data privacy.

• Listening effectively to patient complaints while finding effective solutions through fact finding with staff and providers while monitoring complaints for on-going trends.

Education

High School Diploma or GED (required)

Work Experience

1 year of experience in a clinic or doctor’s office (preferred)

1 year prior authorization experience (preferred)

Training

EPIC Electronic Health Record (preferred)

Many of our opportunities reward* your hard work with:

Comprehensive, affordable medical, dental and vision plans

Prescription drug coverage

Flexible spending accounts

Life insurance w/AD&D

Employer contributions to retirement savings plan when eligible

Paid time off

Educational Assistance

And much more

*Benefits offerings vary according to employment status

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com . If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com