Patient-Centric Insurance Authorization Specialist

Penn Medicine; East Petersburg (Lancaster County); On-site; USD 40,000 - 52,000; Full time

Job summary

Penn Medicine is seeking an Insurance Authorization Specialist to verify patient insurance and manage pre-authorizations in our Financial Clearance Center at East Petersburg, PA. This role supports accurate referrals and smoother revenue cycles across hospital and outpatient services.

Qualifications include a HS diploma or GED (AA/AS preferred) and 1+ year healthcare admin or billing experience. The position emphasizes collaboration with providers, payers, and internal teams to improve

Qualifications

• HS Diploma or GED required.
• Associate of Arts or Science preferred.
• 1+ years' experience in a healthcare related administrative or billing setting.

Responsibilities

• Coordinate pre-authorization process.
• Confirm the authorization is on file in a timely manner.
• Liaise with doctor’s offices, insurance representatives, PFS, and other departments to ensure authorization and/or referrals for services on file and accurate with the payer resulting in maximized reimbursement.
• Resolve registration issues including insurance inquiries and CPT code changes.
• Manage and resolve coverage and authorization issues from intake to final resolution.
• Analyze and research escalated authorization/referral issues professionally.
• Maintain understanding of the revenue cycle including insurance requirements and billing standards.
• Document information in EMR regarding insurance and authorization.
• Analyze and research denials to resolve denied claims with the payer or provider office.
• Evaluate denials to determine if appeals are warranted and collaborate with the payer or practice to resolve issues.
• Support LEAN initiatives and suggest improvements.

Skills

Pre-authorization

Insurance verification

Billing liaison

Education

HS Diploma/GED

AA/AS preferred

1+ years healthcare admin/billing

Tools

EMR

Job description

Penn Medicine is seeking an Insurance Authorization Specialist to verify patient insurance and manage pre-authorizations in our Financial Clearance Center at East Petersburg, PA. This role supports accurate referrals and smoother revenue cycles across hospital and outpatient services.

Qualifications include a HS diploma or GED (AA/AS preferred) and 1+ year healthcare admin or billing experience. The position emphasizes collaboration with providers, payers, and internal teams to improve