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   Current UPMC employees must apply in HR Direct

Surgical Insurance Verification Representative

  • Job ID: 196125487
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours: 8 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: $15 to $21.66 / hour


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.


  • 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.



  • Associate Degree with minimum of 1-year experience with insurance verification authorization or closely related field or in lieu of a High School Graduate with 2-3 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
    • CD-10 Coding with knowledge of EPT 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

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   Current UPMC employees must apply in HR Direct