Patient Access & Financial Clearance Specialist

Highmark Health; Pittsburgh (Allegheny County); On-site; USD 38,000 - 60,000; Full time

Job summary

Allegheny Health Network, part of Highmark Health, seeks an experienced Patient Access professional to handle scheduling, preregistration, and financial clearance with a focus on accurate data, benefit verification, and patient education. You will work with payors, physicians, and families to clarify financial responsibilities.

In this role, you will collect liabilities, process transactions, and ensure timely submission of claims while upholding HIPAA and privacy policies.

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 applications.
• Preferred medical terminology and obtaining insurance verifications.
• Call/Service Center experience.

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; updates data to assure timely bill submission.
• Verifies insurance information through payor contacts via telephone, online resources, or electronic verification system.
• Identifies payor authorization/referral requirements and provides documentation to physicians and payors regarding deficiencies.
• Identifies all patient financial responsibilities, calculates estimates, collects liabilities and posts transactions.
• Delivers positive patient experience and maintains relationships with patients, AHN leadership, staff, and external agencies.
• Maintains productivity, adheres to policies, and completes mandatory training.
• Performs other duties as assigned.

Skills

Scheduling

Pre-registration

Financial clearance

Authorization validation

Customer service

Data entry

Education

High school diploma or GED

Job description

Allegheny Health Network, part of Highmark Health, seeks an experienced Patient Access professional to handle scheduling, preregistration, and financial clearance with a focus on accurate data, benefit verification, and patient education. You will work with payors, physicians, and families to clarify financial responsibilities.

In this role, you will collect liabilities, process transactions, and ensure timely submission of claims while upholding HIPAA and privacy policies.