Patient Access Coordinator I - SVH Urgent Care - Erie - Full Time

Highmark Health; Millcreek Township (PA); Sur place; USD 32 000 - 42 000; Plein temps

Résumé du poste

Allegheny Health Network is seeking a Patient Access professional to support scheduling, preregistration, financial clearance, and authorization processes. The role involves identifying insurance benefits, calculating estimates, collecting liabilities, and maintaining clear communication with patients and care teams.

The position emphasizes delivering a positive patient experience, adhering to policies, and collaborating with diverse teams to ensure accurate and timely bill submission.

Qualifications

• High school diploma or GED; or 1–3 months of related experience and/or training.
• 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 medical terminology knowledge and experience obtaining insurance verifications.
• Call/Service Center experience.

Responsabilités

• Schedules and preregisters patients; validates demographic data and verifies medical benefits; ensures accurate plan codes and COB order.
• Verifies insurance information through payor contacts via telephone, online resources, or electronic verification system.
• Identifies payor authorization/referral requirements and provides documentation and follow-up to physician offices, case-management, and payors.
• Identifies patient financial responsibilities, calculates estimates, collects liabilities, posts payments, and performs daily reconciliation.
• Delivers positive patient experience.
• Collaborates with patients, AHN leadership and staff, physician offices, and external agencies or vendors.

Formation

High school diploma or GED

Description du poste

GENERAL OVERVIEW

Company: Allegheny Health Network

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. Articulates information so patients, guarantors, and family members understand 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 and 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, posts 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.
• Performs other duties as assigned or required.

QUALIFICATIONS

• Minimum: High school diploma or GED; or one to three months of related experience and/or training; or an 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 medical terminology knowledge and experience obtaining insurance verifications.
• Call/Service Center experience.

EEO 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.

COMPLIANCE

This job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. Employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. All employees must comply with 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, applicable federal and state laws, rules, and regulations, and company policies and training requirements.