Patient Access Coordinator I - Neurology - AGH - FT

Highmark Health; Pittsburgh (Allegheny County); In loco; USD 32.000 - 42.000; Tempo pieno

Descrizione del lavoro

Highmark Health's Allegheny Health Network is seeking a Patient Access Representative to schedule, preregister, and verify benefits, delivering clear information to patients about financial responsibilities. The role emphasizes accurate data collection, coordination with payors, and maintaining a positive patient experience while complying with HIPAA.

Ideal candidates have a high school diploma or GED and some related experience; familiarity with medical terminology and insurance verification is

Competenze

• Minimum high school diploma or GED or equivalent with 1–3 months related experience.
• One year of related experience preferred in medical or financial services.
• Experience with insurance verification beneficial.

Mansioni

• Performs scheduling and preregistration, validates patient data.
• Verifies insurance information and plan requirements.
• Collects patient financial responsibilities and processes payments.
• Communicates with physicians, case management, and payors to resolve deficiencies.
• Maintains HIPAA compliance and supports excellent patient experience.

Conoscenze

Customer service

Medical terminology

Insurance verifications

Data entry

Call center experience

Formazione

High school diploma or GED

Descrizione del lavoro

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.* 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.* 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.* 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.* Maintains focus on attaining productivity standards, recommending innovative approaches for enhancing performance and productivity when appropriate.* 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.*