Patient Access Coordinator II - AHN Cancer Institute - Allegheny General Hospital

Highmark Inc

Pittsburgh, PA

JOB DETAILS
SKILLS
Cancer, Case Management, Clinical Data, Clinical Data Collection, Corporate Policies, Customer Escalations, Customer Support/Service, Data Quality, Demographics, Documentation, English Language, Federal Laws and Regulations, Financial Management, Financial Planning, Financial Risk, HIPAA (Health Insurance Portability and Accountability Act), Health Insurance, Health Plan, Healthcare, Hospital, Information/Data Security (InfoSec), Leadership, Legal Standards, Medical Billing, Medical Office, Medicine, Office Management, Operational Support, Organizational Skills, PC Software, Presentation/Verbal Skills, Problem Solving Skills, Process Flow, Reconciliation, Regulatory Compliance, Security Policy, State Laws and Regulations, Team Lead/Manager, Time Management
LOCATION
Pittsburgh, PA
POSTED
30+ days ago

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Administrative ServicesPatient Access Coordinator II - AHN Cancer Institute - Allegheny General Hospital

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Patient Access Coordinator II - AHN Cancer Institute - Allegheny General Hospital

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Open in new tab iconPittsburgh PA 15212 314 E North AvenueCompany Allegheny Health NetworkJob Description GENERAL OVERVIEWThis job 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 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. Trains and assists other team members as necessary.

ESSENTIAL RESPONSIBILITIESConducts 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. 20Verifies insurance information through payor contacts via telephone online resources or electronic verification system. Identifies payor authorizationreferral requirements. Provides appropriate documentation and follow up to physician offices case management department and payors regarding authorizationreferral deficiencies. 20Identifies 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. 20Delivers 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. 10Maintains focus on attaining productivity standards recommending innovative approaches for enhancing performance and productivity when appropriate. 10Adheres to AHN organizational policies and procedures for relevant location and job scope. Completes andor attends mandatory training and education sessions within approved organizational guidelines and timeframes. 10Communicates 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. 10Performs other duties as assigned or required.QUALIFICATIONSMinimumHigh school diploma or GED or one - three months related experience andor training or equivalent combination of education and experience.Two previous years of related experience preferably within a medical setting financial servicessetting andor a demanding customer service environmentExperience operating a PC and using software applicationsPreferredCertification with Healthcare Financial Management Association or Certified Revenue Cycle Representative.CallService 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 HRServiceshighmarkhealth.orgCalifornia Consumer Privacy Act Employees Contractors and Applicants Notice

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Job DetailsJob categoryAdministrative ServicesPosition TypeFull TimePosted03162026LocationsPittsburgh PA 15212 314 E North AvenueLine of BusinessEntityRecruiterHiring ManagerExperience LevelJob FamilyPatient Access-AHNReq IDJ278262

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Highmark Health is an independent licensee of the Blue Cross Blue Shield

Association.

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

HRServiceshighmarkhealth.org.

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About the Company

H

Highmark Inc

Highmark provides millions of people with the security of quality health insurance

Our history of helping families and companies with their health insurance needs dates to the 1930s, when our predecessor companies were established to help Pennsylvania's residents pay for health care.

Highmark was created in 1996 by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) and Blue Cross of Western Pennsylvania (now Highmark Blue Cross Blue Shield). We are now one of the largest health insurers in the United States.

Highmark's officers and board of directors set the company's strategic direction and corporate policies. They are guided by our mission, vision and values.

COMPANY SIZE
1,000 to 1,499 employees
INDUSTRY
Healthcare Services
FOUNDED
1996
WEBSITE
https://www.highmark.com/hmk2/index.shtml