Patient Access Coordinator II / ED - Full Time - Rotational - West Penn

Job Title

Job Description

Creates the first impression of Allegheny Health Network's (AHN) services to patients, families, and other external customers upon arrival. Assume clinical and financial risk of the organization when collecting and documenting information on the patient's behalf. Completes one or more of the following processes (proper patient identification, scheduling, registration, financial clearance, authorization and referral validation, creates estimate, and payment collection when applicable). Connects patient to financial advocacy resources when appropriate, provides or obtains signatures on regulatory paperwork as required. Articulates information in a manner that patients, guarantors, and family members understand so they know what to expect and understand their financial responsibilities.

Displays a strong attention to detail, excellent communication skills, empathy, and compassion for patients and their families. Has the ability to multitask, work swiftly under pressure in a high acuity patient environment, and work collaboratively with healthcare professionals. Must stand for long periods of time and use a computer on wheels at bedside. Adheres to all EMTALA guidelines and AHN policies and procedures while performing routine duties. Follows standard and isolation precautions to provide adequate protections for healthcare workers, patients, and visitors.

Essential Responsibilities

• Conducts scheduling, registration, and admitting functions independently at bedside, validates patient demographic data, identifies and verifies insurance information through payor contacts via telephone, online resources or electronic verification systems utilizing accurate plan code and COB order. Obtains limited clinical data based on service required. Collects and updates all necessary data to ensure timely, accurate bill submission to include workers compensation and motor vehicle claims. Provides or obtains signatures on regulatory paperwork as required.
• 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 accounts and documents for follow up by self-pay vendor or financial advocacy department.
• Delivers positive patient experience. Cooperates with patients, all healthcare personnel, and designated external agencies or vendors. Performs any written or verbal communication necessary to exchange information with designated contacts and promote positive working relationships. Maintains focus on attaining productivity standards and recommends innovative approaches for enhancing performance and productivity when appropriate.
• Maintain cohesive working relationships with healthcare personnel to communicate pertinent information such as alias name changes, and information blocks to prevent release of information. Practices patient confidentiality. Accountable for accurate registration into electronic health record during system downtime with monitoring and reconciliation of every patient for accuracy. Central resource for registration and problem resolution during evenings, weekends and holidays.
• Ability to remain calm and professional when faced with stressful situations. Respond to inquiries from patients, visitors, hospital personnel, government agencies, etc. under all circumstances and conditions.
• Communicates team barriers, process flow or productivity issues to department leader. Assists team members with operational support and training. Assists in resolving patient issues requiring additional oversight in a concise and informative manner as required.
• 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.
• Other duties as assigned or requested.

Qualifications

• Required: High School/GED or one three months related experience and/or training; or equivalent combination of education and experience. Experience operating a PC and using software applications. Two previous years of related experience, preferably within a medical setting, financial services setting, and/or a demanding customer service environment.
• Preferred: Medical terminology and insurance knowledge. Certification with Healthcare Financial Management Association or Certified Revenue Cycle Representative.