Company :

Job Description : 

Weekly Onsite Schedule & Travel Expectations

This role requires travel throughout the AHN network to support Patient Access operations at multiple locations. The anticipated weekly schedule is:

• Monday: West Penn Hospital or Hempfield
• Tuesday: West Penn Hospital
• Wednesday: West Penn Hospital
• Thursday: Forbes Regional Hospital
• Friday: Forbes Regional Hospital

Regular travel between sites is an essential component of this position, providing the opportunity to collaborate with diverse teams and support patients across multiple AHN facilities. Travel schedule may change dependent on department needs.

POSITION SUMMARY:

As a key member of the Patient Access team, this role serves as the first point of contact for patients, families, and external customers, creating a welcoming and professional experience while supporting critical front-end revenue cycle functions. Responsibilities include one or more of the following processes: scheduling, pre-registration, financial clearance, authorization and referral validation, pre-service estimates, and point-of-service collections.

The successful candidate will communicate complex clinical and financial information in a clear, compassionate, and patient-friendly manner, ensuring patients and guarantors understand what to expect and their financial responsibilities before receiving care. This role carries significant responsibility, as accurate collection and documentation of patient information directly impacts both the patient experience and the organization's clinical and financial outcomes.

In addition, this position serves as a resource to the team by providing training, guidance, and support to colleagues as needed, helping to maintain operational excellence and a high standard of customer service across all assigned locations.

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. (20%)
• 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%)
• Communicates team barriers, process flow or productivity issues to team lead. Assists team members with operational support and training. Assists in resolving patient issues requiring additional oversight in a concise and informative manner as required. (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.
• Two previous years 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

• Certification with Healthcare Financial Management Association or Certified Revenue Cycle Representative.
• 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.

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