PRIMARY FUNCTION:

Provide insurance verification for all patients to include: scheduled and unscheduled procedures; inpatients and outpatients; and, 24-hour observations.

ESSENTIAL FUNCTIONS:

• Verify and interpret benefit information based on the insurance carrier insurance eligibility benefits including appropriate authorization number to financially secure accounts 48 hours prior to service. Notifies insurance company within 24 hours of hospital admission
• Interprets coordination of benefits, co-payments, deductibles, co-insurance and out-of-pocket liabilities and collect patient liability pre-service, if applicable.
• Detemines patient liability based on benefits and advises Financial Counselor of their patient’s liability Refers to Financial counselor if patient does not qualify for financial assistance.
• Works with the physician’s practices, patients and family members to obtain all information needed of all service lines within the department.
• Refers patient to Campus Vendor, a contracted Financial Assistance Program, to determine if patient is eligible for medical assistance health insurance.
• Pulls schedules for multiple modalities and or work within assigned system work queue
• Financially secure and/or escalate accounts to include authorization, according to policy, prior to date of service
• Collect patient liabilites pre-service .

• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.

• OTHER FUNCTIONS AND COMPETENCIES:

• Complete all Demographic and Verify Insurance information utilizing computer system
• Resolve demographic and Insurance discrepancies to include mis-match
• Determine Patient Financial Liabilities
• Verify authorization numbers and CPT codes for services rendered
• Collaborate with Case Management to authorize cases that require clinical review
• Ability to problem solve various registration/insurance scenarios

EDUCATIONAL/TRAINING REQUIREMENTS:

High School Diploma or GED required

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CERTIFICATES, LICENSES, AND REGISTRATION:

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EXPERIENCE REQUIREMENTS:

Previous experience in a Healthcare Setting, Hospital or Docotor’s office preferred

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ADDITIONAL INFORMATION:

Experience with Microsoft Word and Excel, Epic, Navinet, STAR, PHS, etc.

Covid Vaccination is a requirement for employment at Jefferson for employees working at Jefferson’s clinical entities or at the University. If you are not currently vaccinated you will be required to receive the vaccination prior to hire date if you are offered employment, unless you request and receive an approved medical or religious exemption from Jefferson.

Jefferson includes Thomas Jefferson University and Jefferson Health, a dynamic university and health system with broad reach across the Delaware Valley. Jefferson is the second largest employer in Philadelphia and the largest health system in Philadelphia based on total licensed beds.

Through the merger of Thomas Jefferson University and Philadelphia University in 2017, our University includes ten colleges and four schools. We are an NCAA Division II university and an R2 national doctoral university offering undergraduate and graduate-level programs that provide students with a forward-thinking education in architecture, business, design, engineering, fashion and textiles, health, medicine and social science.

Jefferson Health, the clinical arm of Thomas Jefferson University, has grown from a three-hospital academic health center in 2015, to an 18-hospital health system through mergers and combinations that include hospitals at Abington Health, Aria Health, Kennedy Health, Magee Rehabilitation and Einstein Healthcare Network. We have over 50 outpatient and urgent care centers; ten Magnet®-designated hospitals (recognized by the ANCC for nursing excellence); the NCI-designated Sidney Kimmel Cancer Center (one of only 70 in the country and one of only two in the region); and one of the largest faculty-based telehealth networks in the country. In 2021, Jefferson Health became the sole owner of HealthPartners Plan, a not-for-profit health maintenance organization in Southeastern Pennsylvania. We are the first health system regionally to create an aligned payer-provider partnership.

Jefferson’s mission, vision and values create an organization that attracts the best and the brightest students, faculty, staff, and healthcare professionals, as well as the most visionary leaders to drive exceptional results.

• OUR MISSION: We improve lives.
• OUR VISION: Reimagining health, education and discovery to create unparalleled value
• OUR VALUES: Put People First, Be Bold & Think Differently and Do the Right Thing

As an employer, Jefferson maintains a commitment to provide equal access to employment. Jefferson values diversity and encourages applications from women, members of minority groups, LGBTQ individuals, disabled individuals, and veterans.