Company :
Allegheny Health Network
Job Description :
GENERAL OVERVIEW:
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 AHN's 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.
Benefits include:
* $1,000 Sign-On Bonus
* *Sign-On bonus is for External Hires only
* Recipient must stay with AHN for a minimum of 1 year
* Re-Hires may not have worked for AHN within the previous 12 months to qualify
* Benefits go into effect the 1st of the month following the start date
* Medical (Highmark Insurance)
* Dental (United Concordia)
* Vision
* Paid Time Off (18 days with 6 paid holidays)
* 401K plan (with match)
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. (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 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%)
* 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.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity.
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