Patient Access Coordinator I / Registration - AHN Forbes Hospital - Full-Time

Highmark Health • Monroeville, PA

1d • Onsite

About The Position

The Patient Access Coordinator I / Registration role involves completing various patient access processes such as scheduling, pre-registration, financial clearance, authorization and referral validation, and pre-serviceability estimations and collections. This position is crucial in creating the initial impression of AHN's services for patients, families, and other external customers. The coordinator is responsible for clearly articulating information to ensure patients, guarantors, and family members understand what to expect and their financial responsibilities. The role carries clinical and financial risk for the organization by accurately collecting and documenting patient information. Key responsibilities include validating patient demographic data, identifying and verifying medical benefits, ensuring accurate plan codes and coordination of benefits, and obtaining limited clinical data to ensure timely and accurate bill submission. The coordinator also verifies insurance information through various channels, identifies authorization/referral requirements, and communicates deficiencies to relevant parties. Financial duties involve identifying patient liabilities, calculating estimates, collecting payments, and performing daily reconciliation, with complex cases escalated to Financial Counselors. A strong focus is placed on delivering a positive patient experience and maintaining excellent working relationships with patients, AHN staff, physician offices, and external agencies. The role also requires adherence to productivity standards and organizational policies and procedures.

Requirements

• High school diploma or GED; or one – three months related experience and/or training; or equivalent combination of education and experience.
• One previous year of related experience, preferably within a medical setting, financial services setting, and/or a demanding customer service environment.
• Experience operating a PC and using software applications.

Nice To Haves

• Medical terminology and obtaining insurance verifications
• Call/Service Center experience

Responsibilities

• Conducts scheduling, and preregistration functions, validates patient demographic data, identifies and verifies medical benefits, accurate plan code and COB order. Obtains limited clinical data based on service required. Corrects and updates all necessary data to assure timely, accurate bill submission.
• Verifies insurance information through payor contacts via telephone, online resources, or electronic verification system. Identifies payor authorization/referral requirements. Provides appropriate documentation and follow up to physician offices, case management department, and payors regarding authorization/referral deficiencies.
• Identifies all patient financial responsibilities, calculates estimates, collects liabilities and post payment transactions as appropriate in the ADT system and performs daily reconciliation. Identifies self-pay and complex liability calculations and escalates account to Financial Counselors as appropriate.
• Delivers positive patient experience. Cooperates with and maintains excellent working relationships with patients, AHN leadership and staff, physician offices and designated external agencies or vendors. Performs any written or verbal communication necessary to exchange information with designated contacts and promote working relationships.
• Maintains focus on attaining productivity standards, recommending innovative approaches for enhancing performance and productivity when appropriate.
• Adheres to AHN organizational policies and procedures for relevant location and job scope. Completes and/or attends mandatory training and education sessions within approved organizational guidelines and timeframes.
• Performs other duties as assigned or required.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees