[Hiring] Patient Advocate @MNGI

Role Description

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 patients.
• 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.

Qualifications

• 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.
• None required certifications/licenses.

Requirements

• Required Knowledge: Microsoft Office applications.
• NextGen (Electronic Medical Record and Practice Management system) and related software preferred.
• Insurance payers preferred.
• Required Skills: Compassionate patient care.
• Active listening.
• Problem solving, 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.

Benefits

• Health Coverage: Medical, Dental & Vision Insurance.
• 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.