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

Highmark Health•Pittsburgh, PA

About The Position

This role completes one or more Patient Access processes, including scheduling, preregistration, financial clearance, authorization and referral validation, and pre-service estimates and collections. It creates an initial impression of AHN’s services for patients, families, and external customers by communicating information clearly so they understand what to expect and their financial responsibilities. The role assumes clinical and financial risk for the organization when collecting and documenting patient information and trains or assists other team members as needed. The position conducts scheduling and preregistration; validates demographic and insurance information; identifies benefit, plan code, and coordination-of-benefits details; and obtains limited clinical information relevant to the service. It verifies insurance and authorization or referral requirements, supports resolution of deficiencies, estimates and collects patient liabilities, posts payments, and reconciles transactions. The coordinator also supports a positive patient experience, maintains working relationships with internal and external contacts, meets productivity standards, follows organizational policies and training requirements, and helps address team or patient issues.

Requirements

High school diploma or GED; alternatively, 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.

Nice To Haves

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

Responsibilities

Conduct scheduling and preregistration; validate patient demographic data, medical benefits, plan code, and coordination-of-benefits order; obtain limited clinical data based on the service; and correct or update information 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 perform daily reconciliation.
Identify self-pay accounts 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 as needed with designated contacts to exchange information 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 and complete or attend required training and education within approved 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.
Protect confidential customer information and comply with HIPAA, data-security requirements, the Code of Business Conduct, applicable laws and regulations, and company policies and training requirements.