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Administrative Appeals Coordinator - PPMC

Job ID: 168723
Category: Clerical/Administrative
Work Type: FT
Location: Philadelphia, PA, United States
Date Posted: Jan 25, 2023
Work Schedule: Days - 40 hours/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?

Penn Presbyterian Medical Center has an opening for an Administrative Appeals Coordinator.
This exciting opportunity to become an Administrative Appeals Coordinator is with our Penn Presbyterian Medical Center (PPMC). PPMC is a renowned center for cardiac care and ophthalmology. The campus includes the Musculoskeletal Center’s outpatient facility at Penn Medicine University City and the Pavilion for Advanced Care, which is home to Penn Medicine’s Level 1 Regional Resource Trauma Center.

Position Description:

  • Provides centralized clinical administrative and data management support to the CRCs and SWs to maximize the efficiency and effectiveness of these roles. This position will assist the department in accomplishing the goals and objectives that include delivery of quality care and expected outcomes in a cost-effective and efficient manner.

Responsibilities:

  • Coordinates activities of staff interaction with third party payors and external regulatory agencies both on site and via telephone and/or mail.
  • Functions as a primary facilitator for payors for the distribution of patient related information including the hospital database and discharge/census reports.
  • Maintains database for the department and the utilization management requirements for the hospital information system and within the department.
  • Work closely with CRC and SW team lead for managing short stay buckets, projects and departmental audits. Escalate issues as necessary to Team Leads.
  • Supports the activities of the Clinical Resource Coordinator in all phases of the Clinical Quality and Utilization Management functions including but not limited to data entry, obtaining and copying medical records and assist with d/c planning process.
  • Collaborates and communicates with other UPHS departments to provide information (i.e. financial class changes, admission/discharge date corrections) necessary to accomplish the goals and objectives of the Clinical Resource Management Department and the organization. Maintains current knowledge about review requirements for all federal, state and third party payer programs in order to function as a departmental resource.
  • Prepares and disseminates, in advance, documents/agendas needed for meetings, appointments and presentations.
  • Opens, reads and priorities and responds to all incoming email, mail and telephone communications.
  • Answer and screen all phone calls. Take appropriate messages for the department.
  • Provide project coordination.
  • Maintain confidential files.
  • Performs any additional duties as required to maintain and assists staff with adhoc projects, photocopies and supports function of the department.
  • Recommends changes in office systems and processes to improve office efficiency, achieve departmental and organizational goals.

Minimum Requirements:

  • H.S. Diploma/GED (Required).
  • Bachelor’s degree will be accepted in lieu of 3+ years administrative experience.
  • 3+ years Administrative experience required and Knowledge of medical terminology, 3rd party payors and data entry required.
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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