Patient Access Coordinator I/Registration - AGH - Full time - Rotating Shifts

Highmark Health•Pittsburgh, PA

10d

About The Position

The Patient Access Coordinator completes one or more patient access processes, including scheduling, preregistration, financial clearance, authorization and referral validation, and pre-service estimates and collections. The role creates an initial impression of AHN’s services for patients, families, and other external customers, and explains information clearly so patients and guarantors understand what to expect and their financial responsibilities. The coordinator assumes clinical and financial risk for the organization when collecting and documenting information on behalf of patients. The position requires adherence to organizational policies, ethical and legal standards, privacy requirements, and information security guidelines. Employees may access confidential customer information and must comply with HIPAA, company privacy and security policies, the Code of Business Conduct, and applicable laws and regulations.

Requirements

High school diploma or GED.
At least one year of related healthcare Revenue Cycle experience, preferably in a financial clearance setting.
Excellent customer service and communication skills.
Experience operating a PC and using software applications.

Nice To Haves

Associate degree.
Call center experience.

Responsibilities

Conduct scheduling and preregistration; validate patient demographic data; identify and verify medical benefits, plan codes, and coordination-of-benefits order; obtain limited clinical data as needed; and correct or update data to support timely, accurate billing.
Verify insurance information using payor contacts, online resources, or electronic verification systems, and identify authorization and referral requirements.
Document and follow up with physician offices, case management, and payors regarding authorization or referral deficiencies.
Identify patient financial responsibilities, calculate estimates, collect liabilities, post payment transactions in the ADT system as appropriate, and complete daily reconciliation.
Identify self-pay cases and complex liability calculations, escalating accounts to Financial Counselors as appropriate.
Deliver a positive patient experience and maintain effective working relationships with patients, AHN leadership and staff, physician offices, and designated external agencies or vendors.
Communicate as needed with designated contacts to exchange information and promote working relationships.
Maintain focus on productivity standards and recommend approaches to improve performance and productivity when appropriate.
Follow AHN policies and procedures relevant to the location and job scope, and complete or attend mandatory training and education within established guidelines and timeframes.
Perform other duties as assigned or required.
Protect covered information, cardholder data, and confidential customer information; comply with HIPAA, privacy and information security policies, the Code of Business Conduct, and applicable laws and regulations.