At UPMC, we are committed to keeping our community safe and healthy as the COVID-19 pandemic unfolds. As our team continues to provide Life Changing Medicine to our patients, our recruiters will continue to fill positions throughout this time. Interviews and other processes may be modified to protect the safety of our candidates and employees. Thank you for your patience.

For more information about UPMC's response to COVID-19, please visit upmc.com/coronavirus.

UPMC Life Changing Medicine
Search Our Jobs

   Current UPMC employees must apply in HR Direct

Surgical Insurance Verification Rep (Harrisburg)

  • Job ID: 409936950
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours: Monday to Friday, 8:00 a.m. to 4:30 p.m.
  • Shift: Day Job
  • Facility: Pinnacle Health Support Services
  • Department: Patient Access
  • Location: 409 South Second Street, Harrisburg PA 17104
  • Union Position: No
  • Salary Range: $13.57 to $21.39 / hour

Description

Purpose:
Creates the hospital account in EPIC and verifies insurance coverage and authorizations have been obtained for all scheduled inpatient and Short Procedure surgery cases prior to date of service.

Responsibilities:
  • Enters authorization information onto Hospital Account in EPIC.
  • Follows up on patient and Physician office concerns or questions.
  • Incorporates new policies and procedures into daily responsibilities and asks supervisor questions when clarification is needed
  • Maintains knowledge of third party requirements (referrals, prior authorizations, notification forms, COB, HMO, Worker's Compensation, Auto Insurance and Managed Care contracts) and insurance compliance.
  • Make recommendations for improving department systems, policies and procedures.
  • Creates hospital account records for all surgical cases. Accounts completed in a timely manner to improve customer satisfaction and allow for referral and authorization prior to patients arrival.
  • Educates referring Physician offices on authorization / referral requirements for surgical procedures.
  • Performs all other duties as assigned or deemed necessary in the department's mission to serve patients.
  • Reviews all inpatient and Short procedure surgery accounts for completion of registration and insurance data. Revises registration with correct insurance, demographics and guarantor information as necessary. Resolves complex insurance verification questions.
  • Maintains working knowledge of insurance plans participating with UPMC Pinnacle.
  • Acts as a liaison regarding billing questions as well as any changes staff need to make to a patient's account to ensure acceptance of a claim.

Qualifications

  • Associate's Degree with minimum of one year experience with insurance verification authorization or closely related field or in lieu of a High School Graduate with two-three years of experience.
  • Able to work in a fast pace environment with minimal supervision. 
  • Able to communicate effectively, especially over the telephone.
  • Medical terminology course completion is preferred. (80% Score within 6 months of employment) 
  • Working knowledge of insurance billing requirements.
  • Computer experience. 
  • Preferred knowledge: EPIC, ICD-10 Coding with knowledge of CPT codes for surgical procedures

Licensure, Certifications, and Clearances:
Clearances must be dated within 90 days

  • Act 33 with renewal
  • Act 34 with renewal
  • Act 73 FBI Clearance with renewal

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

    Total Rewards

    More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life &emdash; because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

    Our Values

    At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

       Current UPMC employees must apply in HR Direct

    Talent Network