Patient Access Coordinator II - Neurology - West Penn - FT

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 services for patients, families, and external customers. The coordinator explains information clearly so patients, guarantors, and family members understand what to expect and their financial responsibilities, and handles information that carries clinical and financial risk for the organization. The role also trains and assists other team members as needed. The position follows organizational policies, completes required training, supports a positive patient experience, and works with patients, AHN leadership and staff, physician offices, payors, and external agencies or vendors. Employees must comply with applicable ethical, legal, privacy, and information-security standards, including HIPAA and the company’s Code of Business Conduct.

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; identify and verify medical benefits, plan codes, and coordination-of-benefits order; obtain limited clinical data as needed; and update data to support timely, accurate billing.
Verify insurance through payor 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 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 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 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 mandatory 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.
Comply with applicable legal and ethical standards, company policies, HIPAA privacy requirements, and information-security guidelines.