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Patient Access Specialist II

2 months ago

Erie, Pennsylvania, United States Highmark Health Full time

Position Overview

This role is integral to the Patient Access department, engaging in essential functions such as scheduling, pre-registration, financial verification, and authorization management. The Patient Access Coordinator II serves as the initial point of contact for patients and their families, ensuring they receive clear and comprehensible information regarding their healthcare services and financial obligations.

Key Responsibilities:

  • Facilitates scheduling and pre-registration tasks, confirming patient demographic information, and verifying insurance benefits and coverage details. Collects necessary clinical data relevant to the required services and ensures all information is accurate for timely billing. (20%)
  • Conducts thorough verification of insurance details through various channels, identifying necessary authorizations and referrals. Communicates effectively with physician offices and payors to address any deficiencies in documentation. (20%)
  • Assesses patient financial responsibilities, calculates cost estimates, and processes payments accurately within the system. Recognizes complex financial situations and refers cases to Financial Counselors when necessary. (20%)
  • Ensures a positive experience for patients by fostering strong relationships with them, as well as with AHN leadership, staff, and external partners. Engages in effective communication to facilitate information exchange and collaboration. (10%)
  • Strives to meet productivity benchmarks and proposes innovative strategies to enhance operational efficiency when applicable. (10%)
  • Complies with organizational policies and procedures relevant to the role, participating in mandatory training and educational sessions as required. (10%)
  • Identifies and communicates any barriers to team performance, assisting colleagues with operational challenges and providing support as needed. (10%)
  • Performs additional duties as assigned or required.

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 two years of relevant experience, preferably in a healthcare, financial services, or customer service environment.
  • Proficient in operating a PC and utilizing various software applications.

Preferred Qualifications:

  • Certification from the Healthcare Financial Management Association or as a Certified Revenue Cycle Representative.
  • Experience in a call or service center environment.

Highmark Health and its affiliates are committed to fostering a diverse and inclusive workplace, prohibiting discrimination based on protected characteristics. We strive to create an environment where all individuals are treated with respect and dignity.

EEO is The Law

Highmark Health is an Equal Opportunity Employer, welcoming applications from individuals of all backgrounds.