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

Highmark Health•Pittsburgh, PA

About The Position

The Patient Access Coordinator 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 a first impression of AHN’s services for patients, families, and other external customers, and explains information clearly so patients, guarantors, and family members understand what to expect and their financial responsibilities. The coordinator assumes clinical and financial risk for the organization when collecting and documenting information on behalf of patients, and trains or assists other team members as needed. The position also requires compliance with AHN policies, the company’s Code of Business Conduct, HIPAA privacy requirements, and information security guidelines. Employees may have access to confidential customer information and must protect it.

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, or demanding customer service environment.
Experience operating a PC and using software applications.

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 data; identify and verify medical benefits, plan codes, and coordination-of-benefits order; obtain limited clinical data based on the required service; and correct or update data to support timely, accurate billing.
Verify insurance information through payor 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 complete daily reconciliation.
Identify self-pay cases and complex liability calculations, escalating accounts to Financial Counselors when 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.
Work toward productivity standards and recommend approaches to enhance performance and productivity when appropriate.
Follow organizational policies and procedures and complete or attend required training and education within approved guidelines and timeframes.
Communicate team barriers, process-flow issues, or productivity issues to the team lead.
Provide operational support and training to team members and assist with resolving patient issues requiring additional oversight.
Perform other duties as assigned or required.