Patient Access Coordinator I - Women's Health - Monroeville - Full-time

About the Role

Completes one or more Patient Access processes (scheduling, pre-registration, financial clearance, authorization and referral validation, and pre-serviceability estimations and collections) to create the first impression of AHN's services for patients, families, and external customers. Articulates information clearly so patients, guarantors, and family members understand what to expect and their financial responsibilities. Assumes clinical and financial risk for the organization when collecting and documenting patient information.

Responsibilities

• Conducts scheduling and preregistration functions, validates patient demographic data, identifies and verifies medical benefits, accurate plan code, and coordination of benefits (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 needed. (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 written or verbal communication to exchange information and promote working relationships. (10%)
• Maintains focus on attaining productivity standards and recommends innovative approaches for enhancing performance and productivity when appropriate. (10%)
• Adheres to AHN organizational policies and procedures. Completes and/or attends mandatory training and education sessions within approved guidelines and timeframes. (10%)
• Performs other duties as assigned or required.

Requirements

• Minimum: High school diploma or GED; or one to three months of related experience and/or training; or equivalent combination of education and experience.
• One 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 insurance verification experience.
• Call/Service Center experience.

This role adheres to ethical and legal standards, including HIPAA and data security guidelines, and complies with the company’s Code of Business Conduct and applicable laws.