Patient Access Coordinator I - Jefferson - Full time - Rotating Shifts

Allegheny Health Network; Clairton (Allegheny County); On-site; USD 34,000 - 48,000; Full time

Job summary

Allegheny Health Network's Patient Access team seeks a detail‑oriented specialist to handle scheduling, pre-registration, financial clearance, authorization, and referral validation. You will present AHN services clearly to patients and families and help them understand their financial responsibilities.

You will verify benefits, collect estimates, and support accurate bill submission while maintaining positive relationships with patients, physician offices, and external partners.

Qualifications

• Must have high school diploma or GED.
• Strong customer service and communication skills.
• Proficient with PCs and common software applications.
• Preferred associate degree and healthcare revenue cycle exposure.

Responsibilities

• Conducts scheduling and preregistration; verifies demographics and benefits.
• Verifies insurance information; communicates with payors and offices about authorizations.
• Identifies patient financial responsibilities, estimates, and post-payment tasks.
• Delivers positive patient experience and maintains relationships with AHN staff and external partners.
• Supports productivity goals and adheres to policies; participates in required trainings.
• Performs other duties as assigned.

Skills

Customer Service

Communication

PC Proficiency

Education

High School/GED

Associate's Degree

Job description

This job 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 have an understanding of their financial responsibilities. Assumes clinical and financial risk of the organization when collecting and documenting information on behalf of the patient.

Company

Allegheny Health Network

Job Description

This job 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 have an understanding of 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 new 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/GED
• Excellent Customer Service and Communication Skills
• Operating PC and using software applications

Preferred

• Associate's Degree
• Call Center Experience
• 1 year with the Healthcare Revenue Cycle, preferably within a financial clearance setting

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.

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.