Patient Access Coordinator I - Edinboro Medical Center - FT

Highmark Health•Edinboro, PA

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 role creates an initial impression of AHN’s services for patients, families, and external customers, and explains information clearly so patients and their representatives understand what to expect and their financial responsibilities. The position also assumes clinical and financial risk for the organization when collecting and documenting patient information. The coordinator supports accurate, timely billing by validating patient demographic and insurance information, identifying benefit and authorization requirements, and correcting records as needed. The role identifies patient financial responsibilities, calculates estimates, collects and posts payments, reconciles transactions, and escalates complex or self-pay accounts to Financial Counselors when appropriate. It also contributes to a positive patient experience through effective communication and professional working relationships, while meeting productivity standards and following organizational policies, training requirements, and privacy and security rules.

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, 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 or service center experience.

Responsibilities

Conduct scheduling and preregistration; validate patient demographic data; identify and verify medical benefits, plan code, and coordination-of-benefits order; obtain limited clinical information as required; and correct or update data to support timely, accurate billing.
Verify insurance information through payor telephone contacts, online resources, or electronic verification systems.
Identify payor authorization and referral requirements, and provide documentation and follow-up to physician offices, case management, and payors regarding 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 them 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 in writing or verbally as needed to exchange information and promote working relationships.
Maintain focus on productivity standards and recommend innovative approaches to improve performance and productivity when appropriate.
Follow AHN organizational policies and procedures relevant to the location and job scope, and complete or attend mandatory training and education within approved 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, applicable laws, and training requirements.