Patient Access Coordinator I - Jefferson - Full time - Rotating Shifts

Highmark Health • Jefferson Hills, PA

3d

About The Position

The Patient Access Coordinator I performs 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 communicates information clearly so patients and guarantors understand what to expect and their financial responsibilities. The position assumes clinical and financial risk for the organization when collecting and documenting information on behalf of patients.

The coordinator conducts scheduling and preregistration, verifies demographic and insurance information, identifies authorization and referral requirements, and addresses deficiencies with physician offices, case management, and payors. The role also identifies and estimates patient financial responsibilities, collects payments, posts transactions, reconciles daily activity, and escalates self-pay or complex liability accounts to Financial Counselors. The coordinator supports a positive patient experience, productive working relationships, and organizational productivity, policy, training, confidentiality, privacy, and security requirements.

Requirements

• High school diploma or GED.
• Excellent customer service and communication skills.
• Ability to operate a PC and use software applications.

Nice To Haves

• Associate's degree.
• Call center experience.
• One year of healthcare revenue cycle experience, preferably in a financial clearance setting.

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 service 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 authorization and referral requirements; and provide documentation and follow-up regarding deficiencies to physician offices, case management, and payors.
• Identify patient financial responsibilities, calculate estimates, collect liabilities, post payment transactions in the ADT system as appropriate, and perform daily reconciliation.
• Identify self-pay and complex liability calculations and escalate 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 in writing or verbally as needed to exchange information with designated contacts and promote working relationships.
• Maintain focus on productivity standards and recommend approaches to enhance 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 guidelines and timeframes.
• Perform other duties as assigned or required.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED