Outpatient Registration & Eligibility Specialist

Penn Medicine, University of Pennsylvania Health System; Doylestown (Bucks County); On-site; USD 42,000 - 62,000; Full time

Job summary

Penn Medicine is seeking staff to complete accurate outpatient pre-registration/registration, verify insurance, obtain needed authorizations, and enter physician orders with precision.

The role emphasizes accurate demographics, coding, and guiding patients to financial assistance as needed. It involves direct interaction with patients in outpatient settings at Penn Medicine facilities.

Qualifications

• Complete accurate pre-registration or registration for outpatient accounts, maintaining standards set for accuracy, positive patient experience and successful reimbursement for services.
• Verify patient’s insurance eligibility and benefits; determine correct insurance plan identification with potentially multiple contracts.
• Secure and/or verify authorization for service; monitor patient account until authorization is completed.
• Enter physician orders accurately into the ADM and ITS systems; check Medical Necessity and ABN’s where applicable.
• Identify and collect patient’s financial responsibility; direct patients to appropriate financial assistance if needed.

Responsibilities

• Pre-Register / Register Patients and positively identify correct medical record and visit account; enter all demographic information and physician-documented reasons/ICD codes.
• Verify insurance eligibility and benefits; determine plan identification, screen for service capitation, and document payer data.
• Secure and verify authorization for service to prevent denials; monitor until authorization is complete.
• Enter physician orders into ADM/ITS; verify Medical Necessity and ABN’s; contact physician offices for updated scripts as needed.
• Identify patient financial responsibility and provide information on financial assistance when appropriate.

Education

High school Diploma or GED

Job description

Penn Medicine is seeking staff to complete accurate outpatient pre-registration/registration, verify insurance, obtain needed authorizations, and enter physician orders with precision.

The role emphasizes accurate demographics, coding, and guiding patients to financial assistance as needed. It involves direct interaction with patients in outpatient settings at Penn Medicine facilities.