Pre-Cert & Insurance Authorization Coordinator

Penn Medicine; West Chester (Chester County); On-site; USD 42,000 - 64,000; Full time

Job summary

Penn Medicine is seeking a Pre-Certification and Insurance Verification Specialist to obtain pre-certification and referrals for inpatient and outpatient services. You will verify benefits, pre-certify registrations, and provide billing support while collaborating with admissions, case management, and medical staff.

Proficient Epic usage and HIPAA compliance are essential. The role requires strong communication with payers, patients, and providers, and includes accurate data entry of payer

Qualifications

• H.S. Diploma/GED required.
• Or equivalent required.
• 3+ years experience in a healthcare environment or education in lieu of experience.

Responsibilities

• Obtain pre-certification and referrals for inpatient and same-day encounters.
• Verify benefits and pre-certify outpatient registrations.
• Provide specialized support in insurance and billing information.
• Assist admissions, business office, case managers and medical staff with payer communication.
• Enter authorization numbers and CPT/ICD codes in Epic.
• Maintain confidentiality per HIPAA and Office of Compliance.
• Pre-register appointments 24 hours in advance.
• Maintain relationships with insurance companies and referring physicians.
• Support revenue cycle by ensuring timely reimbursements.

Education

H.S. Diploma/GED

3+ years experience in healthcare environment or education in lieu of experience

Associate's or Bachelor's degree for education in lieu of experience

Tools

Epic Schedgistration Training

Job description

Penn Medicine is seeking a Pre-Certification and Insurance Verification Specialist to obtain pre-certification and referrals for inpatient and outpatient services. You will verify benefits, pre-certify registrations, and provide billing support while collaborating with admissions, case management, and medical staff.

Proficient Epic usage and HIPAA compliance are essential. The role requires strong communication with payers, patients, and providers, and includes accurate data entry of payer