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Bridgeville, PA 15017 1370 Washington Pike, Suite 107 Company: Allegheny Health Network
Job Description:
This role will support our pediatric expansion. This role will rotate schedules between Monday-Saturday, 7am-8pm.
GENERAL OVERVIEW
Completes one or more of the following processes: • Scheduling • Pre-registration • Financial clearance • Authorization • Referral validation • Pre-serviceability estimations • Collections within Patient Access and creates the first impression of AHNs 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.
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 and referral deficiencies.
Identifies all patient financial responsibilities • Calculates estimates • Collects liabilities and post payment transactions as appropriate • Performs daily reconciliation
Identifies self-pay and complex liability calculations and escalates account to Financial Counselors as appropriate.
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.
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.
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.
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 Companys Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employees responsibility to comply with the companys 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.
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Apply Job Details
Job category: Administrative Services Position Type: Part Time Posted: 2026-02-09T00:27:05.5381280000 Locations: Bridgeville, PA 15017 1370 Washington Pike, Suite 107 Line of Business: Entity Recruiter: Hiring Manager Experience Level: Job Family Patient Access-AHN Req ID: J276759
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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.
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