Patient Access Coordinator I - Primary Care - Braddock - Full Time

Highmark Health•Braddock, PA

About The Position

The Patient Access Coordinator I performs one or more patient-access processes, including scheduling, preregistration, financial clearance, authorization and referral validation, pre-service estimates, and collections. The coordinator creates an initial impression of AHN’s services for patients, families, and external customers, and communicates information clearly so patients and guarantors understand what to expect and their financial responsibilities. The role involves collecting and documenting patient information while managing associated clinical and financial risks to the organization. The coordinator follows organizational policies and procedures, meets productivity standards, completes required training, and protects confidential information in accordance with HIPAA, information security policies, and the company’s Code of Business Conduct. Other duties may be assigned as 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

Medical terminology knowledge and experience obtaining insurance verifications.
Call 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; collect limited clinical data as needed; and correct or update records to support timely, accurate billing.
Verify insurance through payor contacts, online resources, or electronic systems; identify authorization and referral requirements; and follow up with physician offices, case management, and payors on 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 accounts and complex liability calculations, escalating accounts to Financial Counselors as appropriate.
Deliver a positive patient experience and maintain effective working relationships with patients, AHN leaders and staff, physician offices, external agencies, and vendors.
Communicate as needed with designated contacts to exchange information and support working relationships.
Work toward productivity standards and recommend approaches to improve performance and productivity when appropriate.
Follow AHN policies and procedures, attend or complete mandatory training and education within required guidelines and timeframes.
Protect covered, cardholder, and confidential customer information in accordance with HIPAA and company privacy and information-security policies.
Comply with the company’s Code of Business Conduct and applicable laws, regulations, policies, and training requirements.
Perform other duties as assigned or required.