Position Description:

As a Patient Relations Representative III in Neurology you will conduct routine and advanced insurance prior-authorizations, requiring knowledge of insurance companies, verification policies and procedures to ensure proper reimbursement for all clinical care. This role will also independently provide check-in and scheduling for the front desk of the clinic on a rotating basis with colleagues. This work will be conducted in the MCW Adult Neuropsychology Clinic.

Primary Functions: Prior Authorizations & Insurance

• Facilitates accurate authorizations and referrals by using insurance processes and regulations, Neuropsychology data and procedural coding.
• Maintain working knowledge of MCW and affiliate computerized scheduling systems (i.e., Epic,). Utilize appropriate on-line system to verify insurance and government aid eligibility.
• Work with financial team and patient to ensure payment for services rendered based on situation.
• Identifies eligibility by interpreting contract provisions and processes.
• Communicates approval and denial results to internal and external customers.
• Develops and maintains policies and procedures.
• Works with team on regular basis to conduct training for contract evaluation and management and to identify workflow and process improvements.
• Provides support to physicians, clinical and administrative staff regarding pre-authorization appeals and disputes.

Primary Functions: Front Desk and Scheduling

• In person or via telephone, check patients in for their appointment, schedule patient new and follow up appointments, update patient accounts, collect patient demographic and insurance information and answer routine questions regarding medical billing.
• Independently exercise judgment to resolve more complex customer concerns. Transfer concerns to more appropriate personnel when required.
• Documents in electronic medical record and other software tools that are essential to the clinic.
• Coordinate multiple appointments for patients participating in our multi-disciplinary clinics.

Knowledge of quality control, customer service standards, information management, procedural process, and recordkeeping. Computer, technical, interpersonal, oral communication, listening, and patience skills.

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Preferred Schedule:
M-F 8-4:30 or 830-500

Position Requirements:

Appropriate experience may be substituted on equivalent basis

Minimum Required Education: High school diploma
Minimum Required Experience: 3 years
Preferred Experience: Knowledge of Insurance verification process and portals, EPIC

Why MCW?

• Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options
• 403B Retirement Package
• Competitive Vacation and Paid Holidays offered
• Tuition Reimbursement
• Paid Parental Leave
• Pet Insurance
• On campus Fitness Facility, offering onsite classes.
• Additional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc.

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For a brief overview of our benefits see:

Eastern Wisconsin is a vibrant, diverse metropolitan area. MCW is intent on attracting, developing, and retaining a diverse workforce and faculty body that reflects the community we serve. We value diversity of backgrounds, experience, thought, and perspectives to advance excellence in science and medicine. MCW is a welcoming campus community with a strong culture of collaboration, partnership, and engagement with our surrounding community. For more information, please visit our institutional website at .

MCW as an Equal Opportunity Employer and Commitment to Non-Discrimination
The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering a diverse community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.

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