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   Current UPMC employees must apply in HR Direct

Ancillary Insurance Verification Rep.

  • Job ID: 274702065
  • Status: Full-Time
  • Regular/Temporary: Flex
  • Hours:
  • 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

Description

Purpose:
Verifies insurance coverage and authorizations have been obtained for all scheduled ancillary services prior to date of service.

Responsibilities:

  • Search continuously for improvement opportunities and notifies eh supervisor and or team leads of trends.
  • Follows up on physician office and/or patient concerns or questions.
  • 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.
  • Refers uninsured patients, who are unable to pay, to the financial counselors.
  • Knowledge of diagnosis correlation with anatomical study scheduled. (Including contrast levels)
  • Acts as a liaison to technologists, physician offices, and other departments for scheduling and authorization directions.
  • Acts as a liaison to health center staff regarding billing questions as well as any changes health center staff need to make to a patients? account to ensure acceptance of a claim
  • Knowledge of insurance plans, UPMC Pinnacle sites participate with.
  • Knowledge of insurance contracts with Tristan locations.
  • Knowledge of the different protocols between facilities and Radiology groups.
  • Continuing education with insurance plan changes and referral/authorization guidelines
  • Educate referring physician offices on how to obtain authorizations or referrals.
  • All verification is completed daily
  • Accounts are completed in a timely manner to improve customer satisfaction and allow for referral and authorization activities prior to patient's arrival.
  • Enters authorization information onto HAR in Epic
  • Gathers and/or verifies insurance information. Resolves complex insurance verification questions.

 

Qualifications

Associate Degree or equivalent with a minimum of 1-year experience with insurance verification/authorization or closely related field. In lieu of degree a minimum of High School diploma or equivalent with 2-3 years-experience with insurance verification/authorization or closely related field. Working knowledge of basic medical terminology and completion of medical terminology course within six months of employment with passing score of 80%.Excellent verbal and written communication skills. Working knowledge of insurance / billing requirements.Preferred -Prior Epic knowledge preferredICD-10 coding knowledge preferredCPT codes for diagnostics 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 — 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