Patient Access Coordinator II/Registration - AHN Fed North - Full time - Rotating Shifts

Highmark Health • Pittsburgh, PA

18d

About The Position

This role completes 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 services for patients, families, and external customers, explaining information so patients and guarantors understand what to expect and their financial responsibilities. The role handles clinical and financial information on behalf of patients and assumes related organizational risk. It also provides operational support and training to other team members as needed.

The position must follow AHN policies and procedures, complete required training, and comply with applicable ethical, legal, privacy, and information-security requirements, including HIPAA and the company’s Code of Business Conduct. The description notes that duties may include other assigned or required work and may not list every responsibility or qualification.

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.
• Two years 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.
• Comply with applicable ethical and legal standards, company policies, HIPAA privacy requirements, data-security guidelines, and training requirements.

Nice To Haves

• Certification with the Healthcare Financial Management Association or as a Certified Revenue Cycle Representative.
• Call or service center experience.

Responsibilities

• Conduct scheduling and preregistration; validate patient demographic information, medical benefits, plan codes, and coordination-of-benefits order; obtain limited clinical data based on the 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 document and follow up on deficiencies with physician offices, case management, and payers.
• 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 cases 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 as necessary with designated contacts to exchange information and promote working relationships.
• Meet productivity standards and recommend approaches to improve performance and productivity when appropriate.
• Follow organizational policies and procedures for the relevant location and job scope, and complete or attend mandatory training and education within required guidelines and timeframes.
• Communicate team barriers, process-flow concerns, or productivity issues to the team lead; assist team members with operational support and training; and help resolve patient issues requiring additional oversight.
• Perform other duties as assigned or required.

What This Job Offers

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