Patient Access Coordinator I-Esophageal Surgery

Highmark Health; Pennsylvania; On-site; USD 35,000 - 45,000; Full time

Job summary

Highmark Health is seeking a Patient Access Coordinator I in Pennsylvania to enhance the patient experience. Responsibilities include scheduling, verifying insurance, and calculating patient financial responsibilities while maintaining relationships with patients and medical staff.

The ideal candidate will have a high school diploma or GED and experience in a medical or demanding customer service environment. This role requires strong communication and organizational skills along with a commitment to compliance and privacy policies.

Qualifications

• One year of related experience in a medical or customer service setting.
• Familiarity with medical terminology and insurance processes.

Responsibilities

• Conducts scheduling and preregistration functions.
• Verifies insurance information and documents properly.
• Calculates patient financial responsibilities and collects payments.
• Maintains relationships with patients and medical staff.
• Adheres to organizational policies and completes training.

Skills

Customer service

Insurance verification

PC operation

Education

High school diploma or GED

Job description

## Patient Access Coordinator I-Esophageal SurgeryApplyremote type: On-sitelocations: McMurray PA, 15317, 138 Gallery Drtime type: Full timeposted on: Posted Todayjob requisition id: J282768## **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* 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 applicationsPreferred* 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. **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.* *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. 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.*