Penn Medicine, University of Pennsylvania Health System · 2 months ago
Verification Specialist - PMPH
Plainsboro, NJ
Full-time
Onsite
Entry, Mid Level
$17.75/hr - $28.33/hr
2+ years expPenn Medicine is dedicated to providing high-quality patient care, conducting innovative research, and educating future leaders in medicine. The Verification Specialist will be responsible for insurance verification and coordination for various cases to facilitate patient access to clinical services in the Princeton House system.
BiotechnologyEducationHealth CareMedicalTraining
Responsibilities
Possesses significant knowledge of all types in-network and out-of-network health insurance, managed care companies, benefits and policies for commercial, Medicare and Medicaid populations
Possess significant knowledge of various Union related benefits
Obtain insurance information via multiple systems, telephonic or electronic
Contact insurance companies to verify patients’ mental health and substance abuse benefits for both commercial, Medicare, and Medicaid insurance plans across continuum
Perform independently with the knowledge of insurance verification, policy plans and benefits in accordance with PHBH policies and procedures for use across continuum
Perform independently with contracting department notifications to coordinate proper contractual information is relayed regarding patients' co-insurance
Possess significant knowledge around contracts with payers and the need to facilitate single case agreements to ensure accurate and timely patient coverage and reimbursement
Communicates with admissions team, local site and UM on all benefit related problems or alerts
Continues to update knowledge and skills to maintain compliance with all insurance regulations and requirements
Ability to develop a good working relationship with managed care organizations, and provide excellent customer service
Ability to be proactive, demonstrate strong negotiation skills/patient advocacy when interacting with all managed care organizations
Contact insurance companies to obtain evaluation authorization for patients’ mental health and substance abuse benefits to ensure proper payment
Timely re-verify all commercial, Medicare and Medicaid policies within PHBH policy standards to ensure proper patient coverage and payment
Maintain and update information in the SQL database to support benefit sheets for use at the local sites
Inform and support patients of their insurance benefits and or financial obligation to treatment in accordance with PHBH policies and accuracy standards
Ensures that all insurance information regarding urine drug screen testing is documented to the outpatient site appropriately to ensure payment
Qualification
Required
Experience in a healthcare environment or insurance company
H.S. Diploma/GED and 2-4 years' experience
Preferred
Experience with insurance is preferred but will consider candidates who are interested and able to learn the intricacies of benefit plans
5-8 years' experience
Benefits
One of the finest prepaid tuition assistance programs in the region
Company
Penn Medicine, University of Pennsylvania Health System
Penn Medicine is a world leader in academic medicine, setting the standard for cutting-edge research, compassionate patient care, and the education of future health care professionals.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$70.9MKey Investors
BIRD FoundationWarren Alpert FoundationNational Cancer Institute
2025-01-22Grant
2023-01-03Grant· $9.7M
2022-08-18Grant· $5.7M
Leadership Team
Kevin Mahoney
Chief Executive Officer of University of Pennsylvania Health System
John Donohue
Vice President, Enterprise Services
Recent News
The Philadelphia Inquirer
2026-01-03
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