Patient Access Coordinator I - Century III Medical Assoc. - West Mifflin - FT

Allegheny Health Network; West Mifflin (Allegheny County); On-site; USD 35,000 - 45,000; Full time

Job summary

A leading healthcare provider in West Mifflin is seeking a Patient Access Coordinator I. The role involves scheduling, verifying insurance, and collecting patient financial responsibilities, ensuring a positive experience for patients. Ideal candidates have a high school diploma, related experience, and are proficient with computer applications. This is a full-time entry-level position in a healthcare setting.

Qualifications

• High school diploma or GED; or one – three months related experience and/or training.
• One previous year of related experience, preferably in a medical or financial services setting.
• Experience operating a PC and using software applications.

Responsibilities

• Conduct scheduling and preregistration functions and verify patient demographic data.
• Collect and document patient financial responsibilities and perform daily reconciliations.
• Deliver positive patient experience and maintain excellent working relationships.

Skills

Scheduling and preregistration

Insurance verification

Customer service

Education

High school diploma or GED

Tools

PC and software applications

Job description

Patient Access Coordinator I - Century III Medical Assoc. - West Mifflin - FT

Apply for the Patient Access Coordinator I role at Allegheny Health Network.

Company

Allegheny Health Network

Job Description

General Overview

Completes one or more of the following processes (scheduling, pre‑registration, financial clearance, authorization and referral validation and pre‑serviceability estimations and collections) within Patient Access and creates the first impression of AHN's services to patients and families and other external customers. Articulates information in a manner that patients, guarantors and family members understand so they know what to expect and understand their financial responsibilities. Assumes clinical and financial risk of the organization when collecting and documenting information on behalf of the patient.

Essential Responsibilities

• Conducts scheduling, and preregistration functions, validates patient demographic data, identifies and verifies medical benefits, accurate plan code and COB order. Obtains limited clinical data based on service required. Corrects and updates all necessary data to assure timely, accurate bill submission. (30%)
• Verifies insurance information through payor contacts via telephone, online resources, or electronic verification system. Identifies payor authorization/referral requirements. Provides appropriate documentation and follow up to physician offices, case management department, and payors regarding authorization/referral deficiencies. (20%)
• Identifies all patient financial responsibilities, calculates estimates, collects liabilities and post payment transactions as appropriate in the ADT system and performs daily reconciliation. Identifies self‑pay and complex liability calculations and escalates account to Financial Counselors as appropriate. (20%)
• Delivers positive patient experience. Cooperates with and maintains excellent working relationships with patients, AHN leadership and staff, physician offices and designated external agencies or vendors. Performs any written or verbal communication necessary to exchange information with designated contacts and promote working relationships. (10%)
• Maintains focus on attaining productivity standards, recommending innovative approaches for enhancing performance and productivity when appropriate. (10%)
• Adheres to AHN organizational policies and procedures for relevant location and job scope. Completes and/or attends mandatory training and education sessions within approved organizational guidelines and timeframes. (10%)
• Performs other duties as assigned or required.

Qualifications

Minimum Qualifications

• High school diploma or GED; or one – three months related experience and/or training; or equivalent combination of education and experience.
• One previous year of related experience, preferably within a medical setting, financial services setting, and/or a demanding customer service environment.
• Experience operating a PC and using software applications.

Preferred Qualifications

• Medical terminology and obtaining insurance verifications.
• Call/Service Center experience.

Disclaimer

The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Compliance Requirement

This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Equal Employment Opportunity Statement

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

Accessibility and Accommodation

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For accommodation requests, please contact HR Services Online at [e-mail].

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Employees, Contractors, and Applicants Notice.

Seniority Level

Entry level

Employment Type

Full-time

Job Function

Health Care Provider

Industries

Hospitals and Health Care