Coordinator - health

Highmark Health; Pittsburgh (Allegheny County); On-site; USD 35,000 - 50,000; Full time

Job summary

A leading healthcare organization is seeking a Patient Access Representative to enhance patient experience by conducting pre-registration and scheduling tasks. The role requires excellent communication skills and the ability to understand patients' financial responsibilities. With opportunities for growth, candidates with a high school diploma and relevant experience are encouraged to apply.

Qualifications

• Minimum of one year related experience, preferably in healthcare.
• Knowledge of medical terminology and insurance verification processes preferred.

Responsibilities

• Conducts scheduling and pre-registration; validates patient data.
• Calculates financial responsibilities; collects and posts payments.
• Maintains productivity standards and communicates effectively.

Skills

Proficiency with PC and software applications

Communication skills

Customer service skills

Education

High school diploma or GED

Job description

Company

Allegheny Health Network

Job Description

GENERAL OVERVIEW

Completes processes such as scheduling, pre-registration, financial clearance, authorization, referral validation, and pre-serviceability estimations and collections within Patient Access. Creates the first impression of AHN's services to patients and families and other external customers. Articulates information clearly so patients, guarantors, and family members understand their expectations and financial responsibilities. Assumes clinical and financial risk when collecting and documenting patient information.

Essential Responsibilities

• Conducts scheduling and pre-registration, validates patient demographic data, verifies medical benefits, accurate plan code, and COB order. Obtains limited clinical data based on service required. Ensures all data is accurate for timely billing. (30%)
• Verifies insurance information through payor contacts, online resources, or electronic systems. Identifies authorization/referral requirements and follows up with physicians, case management, and payors as needed. (20%)
• Identifies patient financial responsibilities, calculates estimates, collects liabilities, and posts payments. Escalates complex accounts to Financial Counselors. (20%)
• Provides excellent patient experience. Maintains positive relationships with patients, staff, physicians, and external agencies. Communicates effectively with all contacts. (10%)
• Maintains productivity standards and suggests improvements. (10%)
• Adheres to organizational policies, completes mandatory training. (10%)
• Performs additional duties as assigned. (Remaining percentage)

Qualifications

Minimum

• High school diploma or GED, or 1-3 months related experience/training, or equivalent.
• At least one year of related experience, preferably in healthcare, financial services, or customer service.
• Proficiency with PC and software applications.

Preferred

• Knowledge of medical terminology and insurance verification processes.
• Experience in call/service centers.

Disclaimer

This description outlines the general duties and responsibilities and may not include all tasks required. Employees must comply with all applicable laws, policies, and confidentiality requirements, including HIPAA and data security guidelines. The company is committed to accessibility and non-discrimination. For accommodations, contact HR Services at [e-mail].