Precertification Specialist

3 days ago Be among the first 25 applicants

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?

• This position is responsible for obtaining referrals and authorizations for all applicable visits, testing, or procedures performed in an outpatient setting. Verifies eligibility and insurances via various tools and resources. Serves as the in‑house expert for referral and authorization requirements—proactively advises patients and staff on insurance/managed care issues.

• Maintains up‑to‑date knowledge of insurance requirements pertinent to patient services and billing procedures.
• Updates information in EMR including but not limited to demographics, insurance, referral, pre‑authorizations according to UPHS protocol.
• Responsible for facilitating maximum revenue for the practice by managing strategies to collect monies from third‑party payers by ensuring referrals or authorizations have been obtained. Works to obtain any missing data or information so that the billing processes may proceed seamlessly.
• Comprehends insurance and registration information as it relates to the various plans and benefits. Understands the need for referrals and pre‑certs according to insurance requirements and coding.
• Communicates front‑end issues which may impact revenue process to manager.
• Receives and responds to all correspondence, telephone calls, and other inquiries from designated carriers and patients.

• H.S. Diploma/GED (Required)
• 2+ years relevant experience.
• Bachelor of Arts or Science (Preferred). Experience with pre‑certs, referrals and prior authorizations 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.

$19.97 - $30.74/Hourly

As part of their job offer, successful candidates are provided a specific rate, taking into consideration various factors including experience and education.

for information on UPHS’s Benefits.

We are an Equal Opportunity 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.

Entry level

Full‑time

Administrative

Wellness and Fitness Services, Hospitals and Health Care, and Medical Practices