Patient Access Coordinator II - Bellevue - Full time - Day Shift

Highmark Health•Bellevue, PA

10d

About The Position

The Patient Access Coordinator II completes one or more Patient Access processes, including scheduling, preregistration, financial clearance, authorization and referral validation, and pre-service estimates and collections. The role helps create the first impression of AHN’s services for patients, families, and external customers, and explains 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, and may train and assist other team members. The coordinator supports accurate, timely billing by validating patient demographic and insurance information, identifying benefit and authorization requirements, calculating patient liabilities, collecting payments, and reconciling transactions. The role also promotes positive patient experiences, maintains productive working relationships, meets productivity standards, follows organizational policies and training requirements, and escalates issues as appropriate.

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.

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, medical benefits, plan codes, and coordination-of-benefits order; obtain limited clinical data based on the service required; and correct or update information to support timely, accurate bill submission.
Verify insurance information through payor contacts, online resources, or electronic verification systems; identify authorization and referral requirements; and provide documentation and follow-up to physician offices, case management, and payors regarding deficiencies.
Identify patient financial responsibilities, calculate estimates, collect liabilities, post payment transactions in the ADT system as appropriate, and perform daily reconciliation.
Identify self-pay cases 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 with designated contacts to exchange information and promote productive working relationships.
Maintain focus on productivity standards and recommend innovative 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.
Communicate team barriers, process-flow concerns, 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.