Health Benefits Counselor - Office of Patient Accounts - Children's Surgical Associates
Philadelphia, PA, US, 19104
1300 MKT - Wanamaker Building Req ID: 26921
Employment Status: AF - Active - Regular - Full Time
The Health Benefits Counselor is responsible for verifying patient eligibility with insurance carriers, as well as obtaining policy restriction information. Correspond to, and or make telephone contact with insurance companies, parents, patients, primary care physician's offices, and appropriate divisional personnel. Counseling families about insurance coverage and obtaining appropriate referral information via written correspondence and/or telephone.
* Contact insurance carriers to verify eligibility?determine if policy restrictions apply (pre-existing clauses, mandatory second surgical opinion, etc.)?and obtain benefit information.
* Regularly utilizes resource tools?CHOP insurance grid, OPA payer grid, etc.?to correctly determine par payers and relays accurate information to divisions and/or patients as required.
* Initiates pre-surgical estimates in accordance to CSA guidelines by completing all necessary fields and forwarding to the appropriate party for completion.
* Update patient demographic information in Epic registration and notify divisions of changes as necessary.
Required Education and Experience
Required Education: High School/GED
Required Experience: One to three years' experience in health insurance reimbursement; previous medical office experience.
Preferred Education, Experience & Cert/Lic
Preferred Experience: Prior experience obtaining authorizations a plus.
Additional Technical Requirements
* Accuracy in data collection, knowledge of commercial, Medicare, Medicaid and insurance industry operating procedures.
* Knowledge of CPT and/or ICD-9 coding and medical terminology.
All CHOP employees who work in a patient building or who provide patient care are required to receive an annual influenza vaccine unless they are granted a medical or religious exemption.
Children's Hospital of Philadelphia is committed to providing a safe and healthy environment for its patients, family members, visitors and employees. In an effort to achieve this goal, employment at Children's Hospital of Philadelphia, other than for positions with regularly scheduled hours in New Jersey, is contingent upon an attestation that the job applicant does not use tobacco products or nicotine in any form and a negative nicotine screen (the latter occurs after a job offer).
Children's Hospital of Philadelphia is an equal opportunity employer. We do not discriminate on the basis of race, color, gender, gender identity, sexual orientation, age, religion, national or ethnic origin, disability or protected veteran status.
VEVRAA Federal Contractor/Seeking priority referrals for protected veterans. Please contact our hiring official with any referrals or questions.
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Nearest Major Market: Philadelphia
Job Segment: Medical, Counseling, EMR, Patient Care, Surgery, Healthcare
Associated topics: general surgery, laparoscopic, robotics, surg, surgeon, surgery, surgery physician
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.