Patient Access & Insurance Verification Specialist

Penn Medicine; Bala Cynwyd (PA); On-site; USD 42,000 - 54,000; Full time

Job summary

Penn Medicine Bala Cynwyd is seeking a Pre-Registration Specialist to verify patient demographics, insurance, and financial information before service. You will obtain authorizations, referrals, and document payer requirements while collaborating with scheduling and financial counsel to maintain a smooth patient experience.

The role requires 3+ years in Patient Access or related areas, strong communication skills, and knowledge of insurance and billing regulations.

Qualifications

• High School Diploma or GED required.
• 3+ years of experience in Patient Access, Medical Billing, Healthcare Registration, or Customer Service required.
• Knowledge of insurance authorization, pre-certification, CMS medical necessity, and third-party billing requirements.
• Understanding of patient registration, collections, and applicable regulatory requirements.
• Strong customer service, communication, negotiation, and problem-solving skills.
• Knowledge of medical terminology.
• Ability to prioritize, manage multiple tasks, and work effectively in a team environment.

Responsibilities

• Verify and document patient demographic, insurance, and financial information.
• Obtain and document insurance authorizations, referrals, and related coverage details, including effective and expiration dates.
• Complete Medicare Secondary Payer questionnaires and other payer-required documentation.
• Verify insurance eligibility, coverage limitations, copayments, and patient financial responsibility.
• Collect patient payments and establish payment arrangements, including screening for available financing programs.
• Accurately identify primary and secondary insurance payers.
• Document all pre-registration activities and maintain accurate patient account records.
• Identify underinsured or uninsured patients and refer them for financial assistance evaluation when appropriate.
• Communicate financial estimates, payment options, and account information clearly and professionally.

Skills

Insurance authorizations

Pre-certification

CMS medical necessity

Third-party billing

Patient registration

Collections

Customer service

Communication

Negotiation

Problem-solving

Medical terminology

Teamwork

Education

High School Diploma or GED

Job description

Penn Medicine Bala Cynwyd is seeking a Pre-Registration Specialist to verify patient demographics, insurance, and financial information before service. You will obtain authorizations, referrals, and document payer requirements while collaborating with scheduling and financial counsel to maintain a smooth patient experience.

The role requires 3+ years in Patient Access or related areas, strong communication skills, and knowledge of insurance and billing regulations.