Insurance Verification Representative

Th e Insurance Verification Representative provides administrative, insurance verification, and authorization support for Penn Medicine at Home. This role is responsible for verifying patient insurance eligibility, processing insurance information, obtaining and tracking authorizations, maintaining accurate records, and coordinating with managed care organizations to ensure timely reimbursement for services. The ideal candidate has experience in healthcare administration, insurance verification, authorization management, and customer service, with strong organizational skills and attention to detai l. Key Responsibilities In surance Verification & Eligibility Verify insurance coverage and eligibility for new and existing patients. Review patient insurance information to ensure coverage is active and accurate. Identify policy changes, coverage limitations, and benefit discrepancies. Update insurance information within applicable systems and databases. Ensure payer information is current to support uninterrupted patient services. Authorization Management Obtain, process, and track insurance authorizations for home health and related services. Enter authorization information accurately into the designated database. Submit required documentation to managed care organizations and insurance providers. Monitor authorization status and follow up on outstanding approvals. Ensure authorizations are obtained within required timeframes to support reimbursement. Administrative & Documentation Support Process insurance-related paperwork and supporting documentation. Fax clinical and administrative information to managed care companies. Maintain organized electronic and paper records. Ensure all documentation is complete, accurate, and properly filed. Support regulatory and payer documentation requirements. Reporting & Data Management Run assigned operational and authorization reports. Monitor authorization and eligibility data for completeness and accuracy. Maintain tracking records for insurance approvals and reimbursement activities. Assist with data entry and database maintenance functions. Communication & Coordination Serve as a liaison between internal staff, patients, and insurance providers. Communicate professionally with managed care companies regarding authorization requests and coverage issues. Collaborate with clinical and operational teams to support patient care services. Escalate authorization delays, coverage concerns, or reimbursement issues when necessary. Reimbursement Support Follow up with insurance carriers regarding pending authorizations. Assist in securing timely reimbursement by ensuring payer requirements are met. Research and resolve insurance-related discrepancies. Support revenue cycle activities through accurate insurance verification and authorization management. Required Qualifications Hi gh School Diploma or GED requir ed. Experience in: Insurance Verification Prior Authorization Processing Medical Office Operations Revenue Cycle Support Strong data entry and computer skills. Proficiency with Microsoft Office applications. Excellent organizational and time-management abilities. Strong attention to detail and accuracy. Effective verbal and written communication skills. Ability to manage multiple tasks in a fast-paced healthcare envi ronment. Preferred Qualifications Experience in: Home Health Healthcare Insurance Verification Managed Care Medical Billing Authorization Coordination Familiarity with Medicare, Medicaid, and commercial insurance plans. Experience using Electronic Medical Records (EMR) and healthcare billing systems. Knowledge of healthcare reimbursement processes. Key Skills I nsurance Eligibility Verification Prior Authorization Processing Managed Care Coordination Data Entry & Database Management Medical Documentation Customer Service Attention to Detail Report Generation Problem Solving Communication Skills Time Management Multitasking Note- Travel Experience Required #J-18808-Ljbffr