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Precertification Specialist

Job ID: 159181
Category: Other
Work Type: FT
Location: Langhorne, PA, United States
Date Posted: Nov 10, 2022
Work Schedule: Variable

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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?

Summary: 

This position is responsible for registering and securing scheduling appointments associated with outpatient visits and any associated testing. Perform an accurate search for the patient in the database ensuring patient identification and patient safety. Verifies eligibility and insurances via various tools. Requests and creates referrals for specified population. Utilizes principles of customer service, registration and insurance guidelines. Proactively counsel’s patients and staff on insurance/managed care issues. Manages a positive patient experience at all times. Requests, creates and obtains referrals according to payer guidelines. 

  • Department: Langhorne HEM ONCOL
  • Location: Oxford Valley Medical Plaza – 240 Middleton Blvd
  • Entity: Clinical Care Associates

Responsibilities:

Skill Requirements:

· Personal computer skills required - EPIC, Microsoft Office (Word, Excel, PowerPoint and Outlook)

· Extensive knowledge of all managed care insurance and their procedures/regulations required

· Must demonstrate the ability to plan, organize and work independently

· Must display exceptional communication (verbal and oral), organizational and time management skills

· IDX training, competent to schedule appointments, link appointments, make appointments with consults, make all hospital-based appointments, establish visit types for provider, set-up type of patients to be scheduled per provider, with limitations of that provider/first available/next available and capable of enterprise scheduling within the scope of the department's operations

· Must be comfortable with heavy telephone use

 

Credentials:

Education or Equivalent Experience:

· Associates or Bachelor's degree preferred with 2-4 years' relevant experience

· Additional years' experience would be an acceptable proxy for advanced education

· Must be able to work in a team environment.

· Excellent communication (written, verbal) and organization skills required

· Knowledge of medical terminology, managed care, HIPPA requirements and any necessary regulatory requirements a must

· Exercises sound judgement in resolving problems - maintains good rapport with internal/external contacts and patients (and their families) 

· Must be able to adhere to all confidentiality requirements at all times

 

       

      We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

      Live Your Life's Work

      We are an Equal Opportunity and Affirmative Action 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.

         Current UPHS employees must apply HERE
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