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 of Accountabilities:
Responsible for evaluating patient insurance coverage and provide pre-certification for various stages of transplant event. Provide information necessary to obtain prior authorization for transplant and donor related services to insurance and medical review companies. Serve as liaison for division and insurance carriers to ensure proper billing and authorization are obtained in a timely manner. Oversee and facilitate patient access and flow through the BMT transplant program. Assist program administrator with organization and completion of documents describing program activity for health system administration and outside agencies.
- Identifies and effectively communicates financial information to cell therapy and transplant team members, patients and their families with emphasis on identifying any potential patient out-of-pocket liability. Establishes relationships with insurance company case managers and medical directors to facilitate insurance approvals.
- Obtains all necessary payor authorizations. Verifies cell therapy infusion coverage and other medical benefits and acquiring necessary referrals and authorizations for inpatient stays and procedures. Works with patients, their families and team members when possible to help identify insurance coverage gaps.
- Facilitates resolution of patient billing issues. Serves as a liaison with the professional fee and hospital billing offices to resolve billing questions and issues.
- Obtains and documents detailed patient insurance benefit information for all aspects of the cell therapy and transplant process, including, but not limited to, stem cell collection, donor search and cell acquisition, inpatient transplant admission, CART infusions.
- Collaborates with the Managed Care Department to obtain single case agreements, or other arrangements with patient insurance companies, in order facilitate transplant coverage.
- Assists hospital claims department with proper identification of and accounting for global contract cases.
Education or Equivalent Experience:
- H.S. Diploma/GED (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.