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Lead Insurance Verification Coordinator - PreService

Job ID: 160883
Category: Accounting/Finance
Work Type: FT
Location: Philadelphia, PA, United States
Date Posted: Nov 15, 2022
Work Schedule: Full Time, Day Shift, 40 hours per week

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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:

  • The Lead Insurance Verification Coordinator reports directly to the Patient Access Supervisor within the PreService Department at 1500 Market Street. They assist leadership to support and provide first point of contact for workflow and system issues. In conjunction with the supervisor manages staff performances, participate in training sessions, and assist in the development and implementation of appropriate policies and workflows. The Lead Insurance Verification Coordinator is responsible for the financial clearance of patients who have been admitted urgently, emergently or a direct admission from a physician's office. This includes ensuring insurance information is correct by verifying all benefit information, obtaining authorization for hospital admissions, and collaborating with various stakeholders to secure accounts for maximum reimbursement.

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)

    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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