Patient Access Lead: Scheduling, Registration & Billing

Highmark Health; Wexford (Allegheny County); On-site; USD 42,000 - 52,000; Full time

Job summary

Allegheny Health Network is seeking a Patient Access professional to handle scheduling, preregistration, financial clearance, and authorization tasks, while presenting AHN’s services clearly to patients and families. You will gather required information, verify benefits, and explain financial responsibilities with empathy and accuracy.

You will train and assist teammates, support collaboration with physician offices and payors, and strive to deliver a positive patient experience.

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.

Responsibilities

• Performs scheduling and preregistration, 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. (20%)
• Verifies insurance information through payor contacts via telephone, online resources, or electronic verification system. Identifies payor authorization/referral requirements.
• Provides documentation and follow up to physician offices, case management department, and payors regarding authorization/referral deficiencies. (20%)
• 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. (20%)
• 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. (10%)
• Maintains focus on attaining productivity standards, recommending innovative approaches for enhancing performance and productivity when appropriate. (10%)
• Communicates team barriers, process flow or productivity issues to team lead. Assists team members with operational support and training. (10%)
• Performs other duties as assigned or required.

Skills

Customer service experience

PC proficiency

Communication skills

Education

High school diploma or GED

Healthcare Financial Management Association certification (preferred)

Job description

Allegheny Health Network is seeking a Patient Access professional to handle scheduling, preregistration, financial clearance, and authorization tasks, while presenting AHN’s services clearly to patients and families. You will gather required information, verify benefits, and explain financial responsibilities with empathy and accuracy.

You will train and assist teammates, support collaboration with physician offices and payors, and strive to deliver a positive patient experience.