Patient Access Specialist

1 week ago

Pittsburgh, Pennsylvania, United States Highmark Health Full time

Job Overview

This position is responsible for executing various essential processes within Patient Access, including scheduling, pre-registration, financial verification, authorization, and referral validation. The role serves as the initial point of contact for patients and their families, providing critical information in a clear and comprehensible manner. This ensures that patients understand what to expect and are aware of their financial obligations. The role carries the responsibility of managing clinical and financial risks associated with patient information collection and documentation.

Key Responsibilities

  • Prepares and submits billing for consultations and tests conducted at non-Epic facilities.
  • Addresses CRM inquiries regarding appointment scheduling.
  • Manages cash drawer operations in Epic, ensuring accurate balancing and closure.
  • Generates deposit slips and processes bank deposits, confirming transactions in the Epic deposit tool.
  • Conducts pre-registration tasks, including validating patient demographics and verifying medical benefits and insurance details.
  • Collects copayments and outstanding balances, accurately posting payment transactions without estimating costs.
  • Secures authorizations for office visits, tests, and procedures.
  • Facilitates patient check-in and check-out processes.
  • Registers patients for billing not captured through Epic, organizing manual billing for submission to billers.
  • Scans documents into EPIC and prepares patient charts for upcoming visits.
  • Proactively schedules follow-up tests and manages related reports.
  • Handles phone communications, taking messages and relaying information to patients.
  • Engages in charge review and claim edit work queues.
  • Actively manages the patient waitlist.
  • Coordinates procedure scheduling with patients and hospitals, promoting MY CHART sign-up.
  • Sorts, distributes, and prepares incoming and outgoing mail, providing information about services, physicians, and facilities.
  • Communicates with healthcare providers regarding scheduling and patient-related issues.
  • Orders necessary supplies to maintain inventory levels.
  • Assists with medical record requests.
  • Identifies and reports office-related issues to the supervisor.
  • Performs 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 healthcare environment, financial services, or a high-demand customer service setting.
  • Proficient in operating a PC and utilizing software applications.

Preferred Qualifications:

  • Familiarity with medical terminology and insurance verification processes.
  • Experience in a call or service center environment.

Highmark Health and its affiliates are committed to equal employment opportunities and prohibit discrimination against qualified individuals based on protected characteristics. We take affirmative action to employ and advance individuals without regard to race, color, age, religion, sex, national origin, sexual orientation, gender identity, protected veteran status, or disability.

EEO is The Law

Equal Opportunity Employer: Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity

We strive to make our site accessible to all users. For assistance with the application process, please reach out to our HR Services.

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