Patient Access Coordinator II - Neurosurgery - Erie - FT

Highmark Health; Erie (Erie County); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Not specified

Job summary

Allegheny Health Network seeks a Patient Access specialist to manage scheduling, preregistration, and financial processes for patients and families. The role ensures accurate data and timely bill submission while communicating clearly about financial responsibilities.

Ideal candidates have a high school diploma or GED, with 1–3 months related experience, and proficiency in PC software and ADT systems. HIPAA compliance is essential.

Qualifications

• High school diploma or GED required; experience or training acceptable.
• 1–3 months related experience; healthcare or financial services preferred.
• Experience operating a PC and using software applications.

Responsibilities

• Schedules, preregistration and verifies patient demographics and benefits.
• Obtains limited clinical data based on services requested.
• Calculates patient financial responsibility and posts payments in ADT system.
• Delivers a positive patient experience and coordinates with providers and payors.

Skills

Call center experience

Customer service

Data entry

Education

High school diploma or GED

Healthcare revenue cycle certification (preferred)

Tools

ADT system

PC software applications

Job description

Company : Allegheny Health Network

Job Description : requires medical experience. Position schedules surgeries

GENERAL OVERVIEW

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 understand their financial responsibilities. Assumes clinical and financial risk of the organization when collecting and documenting information on behalf of the patient. Trains and assists other team members as necessary.

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%) Communicates team barriers, process flow or productivity issues to team lead.
• Assists team members with operational support and training.
• Assists in resolving patient issues requiring additional oversight in a concise and informative manner as required.
• 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.
• Two previous years 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 Certification with Healthcare Financial Management Association or Certified Revenue Cycle Representative.
• 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.

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.