Patient Access Coordinator I / Behavioral Health - Pittsburgh - Full Time
Patient Access Coordinator I / Behavioral Health - Pittsburgh - Full Time
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1 Vacancy
Job Description
Company :
Allegheny Health NetworkJob Description :
GENERAL OVERVIEW:
Completes one or more of the following processes (scheduling preregistration financial clearance authorization and referral validation and preserviceability estimations and collections) within Patient Access and creates the first impression of AHNs 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.
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. (30%)
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. (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 selfpay 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. Performs any written or verbal communication necessary to exchange information with designated contacts and promote working relationships. (10%)
Maintains focus on attaining productivity standards recommending innovative approaches for enhancing performance andproductivity when appropriate. (10%)
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%)
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.
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
Act 34 Criminal Background Clearance Certificate
Act 33 Child Abuse Clearance Certificate
Act 73 FBI Fingerprinting Criminal Background Clearance Certificate.
Preferred
Medical terminology and obtaining insurance verifications
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 Companys Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore it is every employees responsibility to comply with the companys 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.
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Required Experience:
IC
Employment Type
Full-Time
