What are the responsibilities and job description for the Managed Care Plan Coordinator position at Pennsylvania Medicine?

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Entity : Clinical Care Associates (CCA) - Penn Primary Care (PPC) and Penn Specialty Practices (PSP) of Penn Medicine Medical Group (PMMG)

Department : PennCare - Bucks County

Location : Penn Medicine Bucks County- 777 Township Line Road

Hours : Per Departmental Needs - Full Time

Summary :

The Managed Care Plan Coordinator provides support to the practice and its patients as it relates to managed care insurance plans. The Managed Care Plan Coordinator registers patients, verifies insurance, issues referrals, and assists practice management with policy / protocol development and training as it pertains to managed care plans.

Responsibilities :

Greets and interacts with patients in a positive, pleasant and professional manner and accommodates patient's special needs and to address any questions or concerns

Appropriately handles referral related calls and messages transferred / delivered from other staff personnel per practice procedure

Prepares necessary referral in method as outlined by insurance carrier and practice procedure- paper, electronic, method etc

Works in conjunction with the physician and advance practice providers to prepare and provide appropriate referrals according to practice protocol and insurance policy

Verifies insurance card; verifies completeness and accuracy of referral form

Issues referrals for specialists and diagnostic studies as directed

Maintains up to date knowledge of insurance requirements pertinent to patient service and managed care

Assists practice manager with developing policy and procedures and provides in-services to staff as it pertains to managed care

Updates patient registration in system according to established protocol

Performs duties in accordance with Penn Medicine and entity values, policies, and procedures

Other duties as assigned to support the unit, department, entity, and health system organization

Credentials :

Education or Equivalent Experience :

H.S. Diploma / GED And 2 years of college or work experience (Required)

Associate's Degree Or 2 years medical office experience (Preferred)

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

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