Patient Insurance Coordinator job vacancy in Shriners Children’s – Jobs in Pennsylvania

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We got a new job details in Shriners Children’s & they are Hiring Candidates for Patient Insurance Coordinator

Job Details
Company Name :
Shriners Children’s
Company Location :
Philadelphia, PA 19140
Job Position :
Patient Insurance Coordinator
Job Category :
Jobs in Pennsylvania

Job Description :
Company Overview:

Shriners Children’s is a family that respects, supports, and values each other. We are engaged in providing excellence in patient care, embracing multi-disciplinary education, and research with global impact. We foster a learning environment that values evidenced based practice, experience, innovation, and critical thinking. Our compassion, integrity, accountability, and resilience defines us as leaders in pediatric specialty care for our children and their families.
Job Overview:

Shriners Children’s is the premier pediatric burn, orthopaedic, spinal cord injury, cleft lip and palate, and pediatric subspecialties medical center. We have an opportunity for an full time Patient Insurance Coordinator.
Responsibilities:

Primarily responsible for obtaining authorizations and referrals for all inpatients and outpatient appointments for physicians, therapists, and other ancillary services. Will also perform all registration tasks when updated information is obtained, Responsible for assisting department manager with tasks that are essential for maintaining efficient daily functioning of the department.

Verify Eligibility

Verify insurance using the real-time integrated Cerner tool for participating payers.
Verify insurance for all other payers utilizing their website or make a phone call.
Flag patients with an invalid or inactive response to the Insurance Denied Work list and follow-up with

Patient/guardian to obtain additional information.

Flag patients who do not have active coverage to the Uninsured Work list and perform related questionnaire.
Flag patients needing an authorization or referral so they will populate the Incomplete Authorizations or the

Referral Work lists.

Work with CDI specialist and Physician extenders to facilitate peer to peer appeals for authorization.
Update pre-registration of future visits to ensure all current demographic and insurance information captured when new information is obtained.

Obtain Referrals

Monitor the Incomplete Referral Work list daily.
Contact the patient’s primary care physician to obtain authorization/referral number if unavailable on web

portals.

Enter number in system with start and end date and number of visits.
Escalate account to supervisor if referral is not obtained 48 hours prior to visit.
Update referral status to approved once complete to remove from work list.

Obtain Authorization

Monitor Incomplete Authorization Work list daily.
Contact payer to obtain authorization number using website or phone call.
Enter authorization information in system with accurate health plan comments.
Escalate account to supervisor if authorization is not obtained 48 hours prior to visit.
Update authorization status to appropriate status and follow up timely until final status is determined.

Other Duties as Assigned

Perform above tasks within 48 hours for “walk-up patients, urgent admissions, and designated outside

services.

Perform other Revenue Cycle functions as assigned.
Qualifications:

Education

High School Diploma or GED

Experience

2 Years Insurance prior-authorization in a medical/surgical office and/or hospital setting Preferred

Other

Current full vaccination status required

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