Insurance Verification Rep - PMAH

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 Insurance Verification Representative will provide coordination and team support to the Core Unit staff within Penn Medicine at Home. The individual is primarily responsible for processing insurance information and faxing relevant data to Managed Care Companies. The Insurance Verification Representative is also responsible for running assigned reports, entering authorizations into the database, and following up with Managed Care companies regarding the return of authorizations to secure reimbursement on services. Additionally, s/he will verify insurance eligibility on existing patients to ensure plan coverage is current and changes have not been made. Responsibilities: Works in collaboration with CORE nurses to assure timely communication of insurance authorization information to Managed Care Companies. Follows-up with managed care companies to assure timely receipt of insurance authorizations. Enters insurance authorizations into system as faxed back from companies. Organized, efficient, and timely processing of all concurrent Authorization Management information and requests. Validates insurance coverage on all existing patients on a weekly basis to ensure no change in coverage, or carriers. Utilizes department process and tools to manage the processing of clinical reviews. Works collaboratively with department nurses to assure streamlined workflow. Communicates to CORE unit manager, staff, or clinical team managers regarding missing documentation. Documents all contact with patient, family, and payers in the computer system. Prints and distributes reports as assigned to managers and department staff. Communicates disposition of authorizations as needed. Communicates and documents all patient financial risk and responsibility to the patient, billing coordinator, and clinical team in a timely fashion. Credentials: Education or Equivalent Experience: H.S. Diploma/GED (Required) Equivalent Experience: • And 2+ years Admissions or insurance experience in a home care and/or hospice setting Education Specialization:Business Administration Associate of Arts or Science 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.

Created: 2024-11-03