Company :Allegheny Health NetworkJob Description : 

GENERAL OVERVIEW:

This 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 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.                   

ESSENTIAL RESPONSIBILITIES:

Gathers, prepares and sends billing for consults and testing at non-Epic facilitiesResponds to CRM requests for appointmentsBalances and closes cash drawer in EpicPrepares deposit slip and/or deposits money into bank and confirms deposit in Epic deposit toolCompletes preregistration functions such as validating patient demographic information, identifying and verifying medical benefits and insurance informationCollects copays and prior balances and posts payment transactions.  Does not calculate estimatesObtains authorizations for office visit, testing and proceduresChecks patient in/outRegisters patient for billing not captured through Epic and organizes manual billing and sends to billersScans documents into EPIC and prepares chart for office visitsProactively schedules and follows up with testing and manages follow up reportAnswers the phone, takes messages and forwards calls and calls patient to relay information.Works charge review and claim edit work queuesProactively manages wait listSchedules procedures with patient and hospital and advocates MY CHART sign upCollects, sorts, distributes and prepares incoming and outgoing mail and provides information about services, physicians and facilitiesCommunicates with physicians and midlevel providers regarding schedule and patient issues (no shows)Orders supplies to maintain inventorySupport Medical Record requestProactively identify and report office issues to supervisorPerforms other duties as assignedMust be available to work some evenings and some Saturdays

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 servicessetting, and/or a demanding customer service environmentExperience operating a PC and using software applicationsFor this position, you will also work charge review and claim edit work queues.
You need to have basic posting or claim knowledge and /or experience with submitting claims.

Preferred

Medical terminology and obtaining insurance verificationsCall/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 their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

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