Allegheny Health Network
PatientAccessCoordinator
“Patient Access Coordinator at Allegheny Health Network. Skills: scheduling, pre-registration, financial clearance, authorization and referral validation, pre-serviceability estimations, collections, 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 electroni”
What You'll Achieve.
Attaining productivity standards
Industry & Context.
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 and 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.
What They're Looking For.
Must Have
High school diploma or or one – three months related experience and/or 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
Nice to Have
Medical terminology and obtaining insurance verifications, Call/Service Center experience
What You'll Do.
Completes one or more of the following processes (scheduling
authorization and referral validation and pre-serviceability estimations and collections) within Patient Access
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
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
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.
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.
How You'll Work.
Team & Collaboration
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.
Communication Scope
Articulates information in a manner that patients, guarantors and family members understand so they know what to expect and understand their financial responsibilities.; Performs any written or verbal communication necessary to exchange information with designated contacts and promote working relationships.
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