Penn Medicine
Insurance Verification Rep - Penn Presbyterian Medical Center
Philadelphia, PA 19104 · US
About the role
Description
Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?
Job Title: Per Diem Insurance Verification Rep
Entity: PMC
Department: Business Operations
Location: Penn Presbyterian Medical Center, 51 N 39th Street, Philadelphia, Pa
Summary:
Obtain pre-certification and referrals for inpatient and same day encounters. Verification of benefits and pre-certify all elective, urgent and emergency admissions. Provide specialized support in the areas of insurance and billing information. Support the representatives' solving problems and answering questions. This position will ensure access to integrated healthcare; achieve clinically appropriate authorization to assure optimal reimbursement for the hospital for services provided.
Responsibilities:
• Working knowledge of hospital insurance verification, authorization and reimbursement issues as they relate to information required at time of care.
• Knowledge of EPIC system and PC applications, including Microsoft Office Suite.
• Financially counsel patients, informing them of their insurance benefits and financial responsibilities
• Be a resource for the patient and family; answering questions when able or connecting them to the person who can assist when the information is out of our scope
• Assess admission / outpatient information for appropriateness of setting and utilization of resources to optimize patient outcomes and cost effectiveness
• Obtain detailed and accurate insurance benefit information with given ICD-9 / ICD-10 and CPT codes, which is updated in EPIC Hospital Account Notes using standardization of documentation (including but not limited to effective date, expected reimbursement, patient financial responsibility, referrals, etc.).
• Pre-certify and obtain authorization numbers, which are updated in patient’s EPIC account
• Interact with medical staff and their designees to obtain complete, accurate, timely clinical and financial information required for payer reimbursement.
• Daily follow up with insurance carriers on all pending authorizations and referrals
• Collect copays via Ipayment. Gives receipt for monies collected and update patient payment collected in EPIC.
Education or Equivalent Experience:
- H.S. Diploma/GED (Required)
- Hospital Related Experience preferred
Live Your Life's Work
We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.