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Patient Access Specialist

2 months ago


Pittsburgh, Pennsylvania, United States Highmark Health Full time

Position Overview

This role is essential in executing various processes related to scheduling, pre-registration, financial clearance, authorization, and referral validation, as well as providing pre-serviceability estimations and collections within Patient Access. The position plays a crucial role in shaping the initial impression of Highmark Health's services for patients, families, and external clients. It is vital to communicate information clearly, ensuring that patients and their families comprehend what to expect and understand their financial obligations. This role carries the responsibility of clinical and financial risk for the organization when gathering and documenting patient information.

Key Responsibilities

  • Prepare and send billing for consultations and tests conducted at non-Epic facilities.
  • Address CRM requests for appointment scheduling.
  • Manage cash drawer balancing and closure in Epic.
  • Prepare deposit slips and process bank deposits, confirming transactions in the Epic deposit tool.
  • Conduct pre-registration tasks, including validating patient demographic details and verifying medical benefits and insurance coverage.
  • Collect copayments and outstanding balances, posting payment transactions without calculating estimates.
  • Secure authorizations for office visits, tests, and procedures.
  • Facilitate patient check-in and check-out processes.
  • Register patients for billing not captured through Epic, organizing manual billing and forwarding to billers.
  • Scan documents into EPIC and prepare charts for office visits.
  • Proactively schedule and follow up on testing, managing follow-up reports.
  • Handle phone communications, take messages, and relay information to patients.
  • Manage charge review and claim edit work queues.
  • Effectively manage the waitlist.
  • Coordinate procedure scheduling with patients and hospitals, promoting MY CHART sign-up.
  • Sort, distribute, and prepare incoming and outgoing mail, providing information about services, physicians, and facilities.
  • Communicate with physicians and mid-level providers regarding scheduling and patient issues, including no-shows.
  • Order supplies to maintain adequate inventory levels.
  • Support medical record requests.
  • Identify and report office issues proactively to the supervisor.
  • Perform additional duties as assigned.

Qualifications

Minimum Requirements:

  • High school diploma or GED; or one to three months of related experience and/or training; or an equivalent combination of education and experience.
  • At least one year of relevant experience, preferably in a medical environment, financial services, or a high-demand customer service setting.
  • Proficiency in operating a PC and utilizing software applications.

Preferred Qualifications:

  • Familiarity with medical terminology and experience in obtaining insurance verifications.
  • Experience in a call or service center environment.

Highmark Health and its affiliates are committed to providing equal employment opportunities and prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities. We also prohibit discrimination against all individuals based on race, color, age, religion, sex, national origin, sexual orientation/gender identity, or any other category protected by applicable federal, state, or local law.

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