Patient Access Coordinator I/Registration - AGH - Full time - Rotating Shifts

Highmark Health; Pittsburgh (Allegheny County); On-site; USD 22,000 - 29,000; Full time

Job summary

Highmark Health in Pittsburgh is seeking a Patient Access Specialist to handle scheduling, preregistration, and financial clearance, ensuring accurate billing and clear communication of costs to patients. You will verify benefits, document authorizations, and support patients through the billing process.

The role requires a high school diploma and 1+ year in healthcare revenue cycle, with strong customer service, PC and software skills, and preferably call center experience.

Qualifications

• Minimum High School diploma or GED.
• At least one year of related healthcare Revenue Cycle experience, preferably in financial clearance.
• Excellent customer service and communication skills.
• Experience operating PC and using software applications.
• Associates degree preferred.
• Call center experience preferred.

Responsibilities

• Completes scheduling, preregistration, and financial clearance processes.
• Validates patient eligibility, benefits, and plan details for accurate billing submissions.
• Identifies payor authorization/referral requirements and documents accordingly.
• Calculates patient liabilities and collects payments while reconciling daily activity.
• Delivers positive patient experiences and maintains professional relationships with providers and payors.

Skills

Customer service

Communication skills

Call center experience

Education

High School diploma or GED

Tools

Software applications

PC literacy

Job description

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 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.
• 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 new 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.
• Performs other duties as assigned or required.

QUALIFICATIONS

• Minimum High School diploma or GED required.
• At least one (1) previous year of related healthcare Revenue Cycle experience, preferably within a financial clearance setting.
• Excellent customer service and communication skills.
• Experience operating PC and using software applications required.
• Preferred Associates degree preferred.
• Call center experience preferred.

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.

CALIFORNIA CONSUMER PRIVACY ACT EMPLOYEES, CONTRACTORS, AND APPLICANTS NOTICE

Highmark Health is a national, blended health organization that includes one of America's largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network. Based in Pittsburgh, Pa., Highmark Health's 35,000 employees serve millions of customers nationwide through the nonprofit organization’s affiliated businesses, which include Highmark Inc., Allegheny Health Network, HM Insurance Group, United Concordia Dental, HM Health Solutions and HM Home & Community Services. Highmark Health's businesses proudly serve a broad spectrum of health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions.