Patient Access Coordinator I - Neurology - AGH - FT

Highmark Health•Pittsburgh, PA

39d

About The Position

The Patient Access Coordinator I completes one or more Patient Access processes, including scheduling, preregistration, financial clearance, authorization and referral validation, and pre-service estimates and collections. The position creates the first impression of AHN’s services for patients, families, and external customers, and explains information clearly so patients, guarantors, and family members understand what to expect and their financial responsibilities. The role assumes clinical and financial risk for the organization when collecting and documenting information on behalf of patients. The coordinator follows organizational policies and procedures, completes required training, protects confidential information in accordance with HIPAA and company security policies, and complies with the Code of Business Conduct and applicable laws. Other duties may be assigned or required.

Requirements

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

Nice To Haves

Knowledge of medical terminology and experience obtaining insurance verifications.
Call center or service 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 based on the required service; and update data to support timely, accurate billing.
Verify insurance information through payer contacts, online resources, or electronic verification systems; identify authorization and referral requirements; and follow up with physician offices, case management, and payers about deficiencies.
Identify patient financial responsibilities, calculate estimates, collect liabilities, post payment transactions in the ADT system as appropriate, and perform daily reconciliation.
Identify self-pay accounts and complex liability calculations and escalate accounts to Financial Counselors when appropriate.
Provide 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 applicable AHN policies and procedures and complete or attend mandatory training and education within organizational guidelines and timeframes.
Protect covered information, payment-card data, and other confidential customer information in accordance with HIPAA and company privacy and information-security policies.
Comply with the Code of Business Conduct, applicable laws and regulations, and company training requirements.
Perform other duties as assigned or required.