Patient Access Coordinator II-Breast Surgery-Erie

Highmark Health•Erie, PA

11d

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 helps create a positive first impression of AHN for patients, families, and other external customers by communicating information clearly so they 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 trains and assists other team members as needed. The role is responsible for accurate patient and insurance information, authorization and referral follow-up, estimates and collection of patient liabilities, payment posting and reconciliation, and a positive patient experience. It also supports productivity, compliance with organizational policies and required training, communication of operational issues, and resolution of patient concerns. Employees must comply with the company’s Code of Business Conduct, HIPAA requirements, and information security policies when handling confidential information.

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 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 about 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 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 effective working relationships.
Maintain focus on productivity standards and recommend approaches to enhance performance and productivity when appropriate.
Follow applicable AHN organizational policies and procedures and complete or attend mandatory training and education within required guidelines and timeframes.
Communicate barriers, process-flow concerns, and productivity issues to the team lead; provide operational support and training to team members; and assist with patient issues requiring additional oversight.
Perform other duties as assigned or required.
Protect confidential information and comply with HIPAA, information security policies, applicable laws and regulations, the Code of Business Conduct, and company training requirements.