Preregistration Specialist at Penn Medicine

Penn Medicine; Bala Cynwyd (PA); On-site; USD 42,000 - 66,000; Full time

Job summary

Penn Medicine is seeking a detail-oriented Pre-Registration Specialist to verify insurance, obtain pre-certifications, and clearly explain patient financial responsibilities for outpatient and inpatient services. You will work closely with scheduling and financial counselors to ensure smooth admissions and accurate billing.

Ideal candidates have a high school diploma or GED, 3–5 years of pre-certification experience, and a health-related degree or equivalent experience.

Qualifications

• H.S. Diploma/GED is required.
• 3–5 years of pre-certification experience; associate's or bachelor’s in health-related field preferred.
• Ability to communicate with patients and payers; maintain confidentiality and data accuracy.

Responsibilities

• Review insurance information for accuracy and completeness and obtain pre-certification for procedures.
• Verify eligibility and benefits with carriers via phone or electronic tools.
• Provide required clinical and demographic information to payer for authorization/pre-certification.
• Identify potential quality and utilization concerns and escalate as needed.
• Determine patient out-of-pocket liabilities and coordinate collection.
• Coordinate with Scheduling and Financial Counseling to minimize patient wait times.
• Maintain patient confidentiality and safety in daily duties.

Skills

Insurance verification

Financial clearance knowledge

Patient communication

Education

H.S. Diploma/GED

Associate's or Bachelor's degree in Health-related field

Job description

Description

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. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Summary

• The Pre-Registration Specialist reports to the Supervisor of Financial Clearance. This individual possesses an in-depth knowledge of insurance plans and policies in regard to financially clearing inpatient and outpatient based procedures. The Pre-Registration Specialist is responsible for insurance verification, benefit obtainment, and precertification for all HUP scheduled outpatient surgical procedures and inpatient admissions via telephone and online tools. The incumbent is also responsible for informing patients of any and all out-of-pocket expenses, including copays, coinsurances, and deductibles with the intent to collect and document these financial liabilities. The incumbent will work collaboratively with scheduling, financial counseling, and registration staff members to ensure patient wait times are minimized on the day of service. This individual participates and assists with training and mentoring staff members according to the organization's training programs.

Responsibilities

• Access assignments via work queues to review insurance information registered for accuracy and completeness and places Business Office Review on each account in order to clear cases for surgery.
• Contacts insurance carrier and/or reimbursement sources via telephone and/or electronic tools to verify eligibility and obtain all applicable benefits pertaining to services being rendered.
• Provides required clinical and demographic information to payer to obtain the proper authorization/pre-certification for the services being rendered.
• Identifies potential quality and utilization concerns and refers to Management when appropriate and will follow-up with actions as indicated.
• Determine all patient out-of-pocket liabilities and contacts patients to coordinate collection of all out-of-pocket liabilities.
• Calculates patient’s remaining balances and refers to the Patient Financial Advocate to finalize the method of resolving the patient liability through point of service collections, payment plans, or other arrangements.
• When applicable, refers to Financial Counseling appropriately when the patient has limited benefits or patient is uninsured.
• Meets on a regular basis with Management and communicates clearly the progress and status of all assigned functions and assists in projects for the department to enhance patient care and quality assurance.
• Exercises complete patient confidentiality in all dealings with patient information and demonstrates an awareness of patient/employee safety when carrying out daily responsibilities of their position.

Education or Equivalent Experience

• H.S. Diploma/GED (Required)
• Education Specialization:Equivalent Experience:And 3-5 years minimum of Pre-certification experience
• Associate of Arts or Science
• Education Specialization:Associates or Bachelors’ Degree in Health related fieldEquivalent Experience:And 3-5 years minimum of Pre-certification experience

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. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.