Patient Access Liaison II

PROGRESSIONS INC•Philadelphia, PA

8d•Onsite

About The Position

Malvern Behavioral Health is seeking a full-time Patient Access Liaison II for its acute inpatient behavioral health facility in Philadelphia, Pennsylvania. The position reports through the Finance department and is responsible for researching and verifying patient healthcare coverage, benefits, and payer requirements for reimbursement. The liaison verifies insurance through online portals and by contacting insurance companies to obtain current benefit details, authorization information, and claim-submission requirements. The role involves discussing insurance coverage and benefit details with patients, calculating and explaining estimated out-of-pocket responsibility, and requesting and accepting upfront payments by credit card or check. The liaison updates the billing system, documents verification information, and attaches supporting documents to patient accounts. The position works closely with Admissions, Utilization Management, and Patient Accounting, while providing customer service to patients and families and maintaining confidentiality of patient information.

Requirements

High school diploma or equivalent required.
Client-focused and team-oriented, with strong interpersonal and communication skills.
Able to adapt to sudden changes in workload, emergencies, or staffing.
Dependable, with problem-solving skills and a focus on compliance and performance quality.
Able to perform the essential duties satisfactorily, with reasonable accommodation as applicable.
Able to perform sedentary work, including lifting up to 10 pounds occasionally and sitting, walking, and standing as needed.
Able to communicate by speaking and to hear and perceive sounds.

Nice To Haves

Bachelor's degree preferred.
Knowledge of addictive diseases preferred.
Healthcare, Admissions, or insurance experience is a plus.

Responsibilities

Research and verify patient healthcare coverage, benefits, and payer requirements for reimbursement.
Use insurance portals, including Promise (EVS), NaviNet, Availity, and PEAR, to verify insurance.
Call insurance companies and obtain current benefit details, authorization information, and claim-submission information.
Communicate with patients or responsible parties about insurance coverage, benefits, financial obligations, and estimated out-of-pocket costs.
Verify that insurance plans are active and check for upcoming termination dates, deductibles, coinsurance, and copayments.
Calculate patient responsibility and clearly explain estimated out-of-pocket balances, coverage limits, and policy benefits to patients or guarantors.
Request and accept upfront estimated-balance payments by credit card or check.
Communicate with a supervisor about admissions requiring payment plans.
Update the billing system with insurance and benefit information and ensure verification documentation is attached to patient accounts.
Accurately document account information and scan documents into patient accounts.
Check for prior outstanding balances, explain them to patients, and assist with setting up payment plans for prior patient activity balances.
Assist the Admissions team by obtaining pertinent information and arranging for admission documentation to be signed as needed.
Communicate by phone with patients, responsible parties, insurance providers, and managed care companies.
Maintain strict confidentiality of patient information in accordance with HIPAA guidelines.
Provide excellent customer service to patients and families.
Participate in continuing education, in-services, and other training for professional growth.
Perform other duties assigned in support of Malvern Health's vision and values.