Temporary Insurance Coordinator in Philadelphia, PA at Shriners Hospitals for Children

Date Posted: 10/24/2020

Job Snapshot

  • Employee Type:
  • Location:
    3551 North Broad Street
    Philadelphia, PA
  • Job Type:
  • Experience:
    At least 2 year(s)
  • Date Posted:

Job Description

Primarily responsible for obtaining authorizations and referrals for all inpatient & outpatient services for physicians, therapists, and other ancillary services. Will also perform all registration and scheduling tasks when assigned. Also responsible for assisting department manager with tasks that are essential for maintaining efficient daily operations of the department.

Pre-register Patients

• Monitors work list daily and calls parent/parent to pre-register 10 days prior to appointment date.

• Obtain and/or verify all demographic information in Cerner system. Key demographic fields include the 15 items in the policy.

• Obtain and/or verify all patient financial information in Cerner system. Key insurance information includes the 6 items in the policy.

Verify Eligibility

• Verify insurance using the real-time integrated Cerner tool for participating payors.

• Verify insurance for all other payors 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.

• Flag patients needing an authorization or referral so they will populate the Incomplete Authorizations or the Referral Work lists.

• Complete Medicare Secondary Payor Questionnaire if patient is a Medicare beneficiary.

• Update pre-registration as complete to remove from work list.

Obtain Referrals

• Monitor the Incomplete Referral Work list daily.

• Contact the patient's primary care physician to obtain referral number.

• 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 payor to obtain authorization number using website or phone call.

• Enter authorization information in system with start date and end date and link number to appropriate encounter.

• Escalate account to supervisor if authorization is not obtained 48 hours prior to visit.

• Update authorization status to approved once complete to remove from work list.

*** This position will report to both our Philadelphia and Doylestown locations ***

Job Requirements

2-5 years' experience with insurance verification, obtaining authorizations & referrals in a medical office/hospital setting- required.

Knowledge of third party billing- preferred.

Bi-lingual in Spanish, preferred.