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Hospital Claims Processor II

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Job ID: 201272
Category: Clerical/Administrative
Work Type: FT
Location: Philadelphia, PA, United States
Work Schedule: 8hr Days

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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?

Entity: CORP

Department: Fin Mgmt Patient Acct Admin

 Location: Centre Square West Tower- 1500 Market Street

Hours: 8hr Days


  • The Hospital Claims Processor II processes claims in the billing claim queues, as assigned, using established procedures and ensuring timely and accurate completion.


  • Claims Processing: Work assigned billing work list and/or EPIC work queues. Strive to achieve zero work in procress by the end of each week. Adhere to the Quality Review and Billing Productivity standards established for each unit or individual. Correct held claims in claim queues using established procedures. Fully utilize information in SMS and Claim Agent in order to ensure billing is complete and accurate. Resolve billing issues by promptly opening a TRAC QUIC Bucket or assigning to the appropriate department's work queue in EPIC to request assistance from an eternal department. Clearly document and initial all adjustments to billed charges that are not reflected in the Patient Accounting System (SMS/EPIC). Process secondary payor claims using established procedures. Monitor and correct, as necessary, electronic confirmation reports daily. Communmicate failed transmissions immediately to entire Patient Accounting Management team. Communicate billing claim queue issues to the Billing Manager, including charge and coding errors. Distribute and mail all hard-copy claims daily.Keep updated on all third-party billing requirements and changes for insurance types within the area of responsibility. Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.

    Education or Equivalent Experience:

    • H.S. Diploma/GED (Required)
    • And Experience in performing clerical and administrative job functions in a business operation. Education Specialization:

    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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