Patient Access Coordinator I / Behavioral Health - Pittsburgh - Full Time - job 1 of 2
Company :
Allegheny Health NetworkJob Description :
GENERAL OVERVIEW:
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.
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 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. 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 and productivity 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 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.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Average salary estimate
If an employer mentions a salary or salary range on their job, we display it as an "Employer Estimate". If a job has no salary data, Rise displays an estimate if available.
5280 Veterinary Care seeks a friendly, detail-oriented Veterinary Receptionist to provide compassionate front-desk and client-support services at our Denver hospital.
Conduit is seeking an Integrations Engineer to support client API integrations, resolve technical issues, and deliver smooth onboarding experiences for our payments platform.
Hanna Interpreting Services is hiring a detail-focused Call Center Representative to manage client calls, verify data, and support accurate recordkeeping in a hybrid role.
CGS Federal seeks an FHA Mortgage Origination Representative to deliver accurate, professional FHA guidance via phone and email for a major federal program.
CenterWell Senior Primary Care is hiring a detail-oriented Medical Receptionist to manage front-desk duties, support patient-centered care, and maintain accurate records at our Richmond clinic.
Spear Physical and Occupational Therapy is looking for a welcoming, communicative Care Coordinator to ensure exceptional patient experiences and smooth clinic operations at our City Point Brooklyn location.
Provide front-desk and leasing administrative support for WinnCompanies' military housing office at Holloman AFB, ensuring excellent customer service and efficient office operations.
Covenant Health Fitness Center is hiring a customer-focused Front Desk Receptionist to manage tennis desk operations, reservations, and member inquiries during variable PRN hours.
Contact Government Services (CGS) seeks an FHA Mortgage Servicing Representative in Indianapolis to provide FHA guideline support and customer service across phone and email channels for a federal client.
Truist is hiring a Universal Banker in Savannah to handle client transactions, support sales and outreach, and deliver high-quality branch service.
Destination Knot is hiring a remote Hospitality Customer Service representative to help clients research, book, and manage hotel reservations with professional, detail-oriented support.
Coinbase is hiring a Complaints Analyst III to lead complex consumer complaint investigations and ensure compliance with regulatory requirements across support and compliance teams.
Support enterprise customers as a Customer Support Engineer specializing in Docker and containerization technologies while collaborating with engineering to drive resolutions and improve support workflows.
To create a remarkable health experience, freeing people to be their best.
48 jobs
🔮
Hi, I'm Risa! Your AI Career Copilot
you, just ask me below!
