Healthcare Insurance Specialist
3 weeks ago
Job Summary:
The Insurance Verification Analyst is responsible for obtaining insurance pre-certification and ensuring timely reimbursement. This role involves verifying eligibility, obtaining benefits, and ensuring referrals, pre-determination, and/or authorization requirements have been completed.
Key Responsibilities:
- Perform follow-up on assigned third-party accounts for scheduled surgeries and diagnostic appointments.
- Verify eligibility, obtain benefits, and ensure referrals, pre-determination, and/or authorization requirements have been completed.
- Utilize web-based applications and/or internet resources to follow up on outstanding items.
- Process correspondence from insurance companies, case management, and other departments within specified time limits.
- Provide patients with an estimate of their out-of-pocket expenses and attempt to collect payment and/or offer payment plan arrangements prior to visit.
- Follow established department protocols to communicate rescheduling/cancellation of scheduled surgeries, procedures, and appointments if authorization is not obtained prior to date of service.
- Review Verification Work queues to ensure that authorization and/or referrals are obtained as per the established timelines of the department.
Requirements:
- H.S. Diploma/GED (Required)
- At least two (2) years' experience working with healthcare insurance
- Bachelor of Arts or Science
- Vocational/Technical School/Diploma Program preferred
- Associate of Arts or Science
- Associate's Degree preferred
About Penn Medicine:
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. 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.
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