Lead Insurance Verification Coordinator - PreService

Responsibilities:

• Leads Insurance Verification Coordinators with confirming eligibility, benefits and precertification with insurance carriers for patients unscheduled admissions.
• Ensures accuracy of all information conveyed in authorization request and addresses errors in a timely manner through continual, direct collaboration with team members.
• Responsible for using online tools for benefits, reviewing medical criteria/policy, prior plan approval (PPA) requirements, initiating and obtaining authorizations.
• Obtaining necessary authorization for patient services. Applicant must have thorough knowledge of insurance guidelines for urgent, emergent and maternity admissions.
• Ensures employees have appropriate training and other resources to perform their jobs; responds to and resolves/escalates employee relations issues expressed by team members.
• Maintains expertise in insurance requirements and authorization workflows; organizes, communicates, and educates team members on policy changes; successfully educates staff and holds team accountable for implementing applicable process changes.
• Identifies, implements and leads measurable process improvement initiatives; coordinates with management to ensure results are met and sustained; leads service improvement initiatives.
  
  
•   Performs duties in accordance with Penn Medicine and entity values, policies, and procedures.
  
•   Other duties as assigned to support the unit, department, entity, and health system organization.  
  

Credentials:

Education or Equivalent Experience:

• H.S. Diploma/GED (Required)
• 2+ years healthcare registration, pre-registration or financial counseling
• Bachelor of Arts or Science (Preferred)