Patient Access Coordinator I - North Versailles - Full Time

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. Creates the first impression of AHN's services to patients, families, and other external customers. Articulates information clearly so patients, guarantors, and family members understand what to expect and their financial responsibilities. Assumes clinical and financial risk of the organization when collecting and documenting information on behalf of the patient.

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 posts payment transactions as appropriate in the ADT system. Performs daily reconciliation. Identifies self-pay and complex liability calculations and escalates accounts to Financial Counselors as appropriate. (20%)
• Delivers a 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 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.

Requirements

• Minimum high school diploma or GED; or one to 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 Qualifications

• Medical terminology and obtaining insurance verifications.
• Call/Service Center experience.

This job adheres to ethical and legal standards, including compliance with HIPAA and data security guidelines. Employees must protect covered information, cardholder data, and other confidential customer information at all times.