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Description

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?

Fulltime/40 Hours Per Week

Schedule: 7:30am-4:00pm

**POSITION SUMMARY:** The primary role of the Patient Advocate is to guide and direct patients safely and efficiently through the bariatric program. The Patient Advocate is the “concierge” for the bariatric surgery patient and ensures that pre-surgery program requirements and clearances are met, in line with surgeon guidance.

**ESSENTIAL FUNCTIONS** : Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:

+ Verifies insurance benefits for all patients within 72 hours of seminar attendance.

+ Performs insurance pre-authorizations after program completion.

+ Develops expertise on requirements for authorization for each insurance company with which the program works, including diet history, pertinent co-morbid conditions, medically supervised weight loss and psychological evaluation requirements.

+ Calls patients to explain insurance benefits and options, if no insurance coverage exists.

+ Counsels patients with exclusions on self-pay and financing options.

+ Promotes medically supervised weight loss options for patients without surgical coverage.

+ Provides a favorable first impression to potential patients; maintains a high degree of patient satisfaction; focuses on delivering excellent customer service.

+ Enters patient data and appointment information on web-based tracking system.

+ Acts as a contact person for all non-clinical patient questions and concerns.

+ Reports pipeline status to Program Manager and surgeons on a monthly basis.

+ Develops and completes “clearance reports” to assess program pull-through.

+ Tracks electronic seminar attendance completion and helps patients get established in the bariatric program.

+ Tracks appointments and exercise/nutrition classes.

+ Communicates with patients on a regular basis to ensure program requirements are met in a timely manner.

+ Works closely with Bariatric coordinator (nurse) to ensure special testing or clearances are obtained, as specified by surgeon.

+ Ensures that any diagnostic test results ordered for that specific patient are available for surgeon review and charted appropriately.

+ Tracks patient status and all insurance and clinical requirements in tracking tool.

+ Obtains insurance pre-certification; routinely corresponding with insurance companies on a variety of issues, including provision of office notes, patient compliance to insurance guidelines and health status.

+ Coordinates insurance appeals for those cases that are denied a pre-certification

+ Prepares information for surgeon review and communicates grounds for appeal to insurers.

+ Schedules surgeon pre-operative appointment for patient.

+ Schedules the initial consult with the surgeon of choice.

+ Schedules surgery for the patients and forwards all necessary operative forms to the hospital.

+ Ensures a smooth, seamless process for the patient and continuity of care.

+ Practical knowledge of computers and computer systems, including knowledge of MicroSoft Office (primarily Excel and Word).

+ Organizational skills to accurately keep track of patient status

+ Time management and multi-tasking capability to monitor numerous patients simultaneously

+ Ability to function as part of a team and promote teamwork

+ Ability to think analytically to correctly interpret insurance policy requirements and to clearly explain these to patients

+ Motivation to assist patients in fulfilling their requirements to surgery

+ Compassion to put the patient first

+ Interpersonal skills to effectively and accurately communicate with patients

+ Ability to compose and present reports. Ability to navigate insurance company guidelines & policies

MINIMUM REQUIRED QUALIFICATIONS

+ High school degree or GED

+ Two to three (2 - 3) years related experience in a medical office, preferably surgery-based

+ Associates or Bachelors degree

+ Experience working in the Bariatric field

+ Experience working in a surgical clinic setting

+ 1-3 years working with insurance companies and obtaining authorizations

+ Experience with ICD and CPT coding

+ Bilingual/Spanish speaking desired

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 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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