About The Position

GENERAL OVERVIEW: This job completes one or more of the following processes (scheduling, pre-registration, financial clearance, authorization and referral validation and pre-serviceability estimations and collections) within Patient Access and creates the first impression of AHN's services to patients and families and other external customers. Articulates information in a manner that patients, guarantors and family members understand so they know what to expect and have an understanding of their financial responsibilities. Assumes clinical and financial risk of the organization when collecting and documenting information on behalf of the patient. Assists with onboarding new hires to the department and acts as a subject matter expert to support as needed. ESSENTIAL RESPONSIBILITIES Conducts scheduling, and preregistration functions, validates patient demographic data, identifies and verifies medical benefits, accurate plan code and COB order. Obtains limited clinical data based on service required. Corrects and updates all necessary data to assure timely, accurate bill submission. (20%) Verifies insurance information through payor contacts via telephone, online resources, or electronic verification system. (20%) Identifies all patient financial responsibilities, calculates estimates, collects liabilities and post payment transactions as appropriate in the ADT system and performs daily reconciliation. Identifies self-pay and complex liability calculations and escalates account to the Financial Advocacy Department as appropriate. (20%) Delivers positive experience and superior customer service when interacting with all patients, AHN leadership and staff, physician offices and designated external agencies or vendors. Performs any written or verbal communication necessary to exchange information with designated contacts in a positive and effective manner. (10%) Assists with onboarding new hires to the department, and acts as a subject matter expert to support team as needed. Engages team with registration and payor related changes to ensure understanding and compliance. Assists department leadership with problem solving related issues as requested. (10%) Maintains focus on attaining productivity standards, recommending new approaches for enhancing performance and productivity when appropriate. (5%) Accountable for following all downtime procedures during a system downtime, and completing an accurate registration when the system recovers in a timely manner. (5%) Adheres to AHN organizational policies and procedures for relevant location and job scope. Completes and/or attends mandatory training and education sessions within approved organizational guidelines and timeframes. (5%) Communicates team barriers, process flow or productivity issues to department leadership, while taking the initiative to participate in problem solving activities. (5%) Performs other duties as assigned or required.

Requirements

  • High School/GED
  • 2 years in the Healthcare Revenue Cycle, preferably within a financial clearance setting
  • Excellent Customer Service and Communication Skills
  • Operating PC and using software applications

Nice To Haves

  • Associate's Degree
  • Call Center experience
  • 3 years of relevant experience

Responsibilities

  • Conducts scheduling, and preregistration functions, validates patient demographic data, identifies and verifies medical benefits, accurate plan code and COB order.
  • Obtains limited clinical data based on service required.
  • Corrects and updates all necessary data to assure timely, accurate bill submission.
  • Verifies insurance information through payor contacts via telephone, online resources, or electronic verification system.
  • Identifies all patient financial responsibilities, calculates estimates, collects liabilities and post payment transactions as appropriate in the ADT system and performs daily reconciliation.
  • Identifies self-pay and complex liability calculations and escalates account to the Financial Advocacy Department as appropriate.
  • Delivers positive experience and superior customer service when interacting with all patients, AHN leadership and staff, physician offices and designated external agencies or vendors.
  • Performs any written or verbal communication necessary to exchange information with designated contacts in a positive and effective manner.
  • Assists with onboarding new hires to the department, and acts as a subject matter expert to support team as needed.
  • Engages team with registration and payor related changes to ensure understanding and compliance.
  • Assists department leadership with problem solving related issues as requested.
  • Maintains focus on attaining productivity standards, recommending new approaches for enhancing performance and productivity when appropriate.
  • Accountable for following all downtime procedures during a system downtime, and completing an accurate registration when the system recovers in a timely manner.
  • Adheres to AHN organizational policies and procedures for relevant location and job scope.
  • Completes and/or attends mandatory training and education sessions within approved organizational guidelines and timeframes.
  • Communicates team barriers, process flow or productivity issues to department leadership, while taking the initiative to participate in problem solving activities.
  • Performs other duties as assigned or required.
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