Allegheny Health Network Careers

Date Posted: 10-12-2016
Position Number: 53675

Location: Allegheny General Hospital

Allegheny Health Network is an integrated delivery network focused on preserving health care choice and providing affordable, high-quality care to the people in our communities.  With more than 14,000 employees including 7,400 health care professionals, nearly 200 primary care and specialty care practices, Allegheny Health Network includes seven hospitals in Pennsylvania with nearly 2,400 licensed beds.

Allegheny Health Network’s clinical expertise ranges from primary care to the most complex surgical procedures.  Services include cancer diagnosis and treatment, cardiovascular care, neurological and neurosurgical services, organ transplantation, orthopedic and rehabilitation services, and women’s health.

Department: Registration

Status: full-time

Shift: Must be available for all shifts, weekends, and holidays

Union/ Non-union: union

Job Summary: 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 have an understanding of their financial responsibilities. Assumes clinical and financial risk of the organization when collecting and documenting information on behalf of the patient. Trains and assists other team members as necessary.

Job Responsibilities:

• Conducts scheduling, and preregistration functions, validates patient demographic data, identifies and verifies medical benefits, accurate plan code and COB order.
• Obtains limited clinical data based on service required.
• Corrects and updates all necessary data to assure timely, accurate bill submission.
• Verifies insurance information through payor contacts via telephone, online resources, or electronic verification system.
• Identifies payor authorization/referral requirements. Provides appropriate documentation and follow up to physician offices, case management department, and payors regarding authorization/referral deficiencies.
• 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 and complex liability calculations and escalates account to Financial
• Counselors as appropriate.
• Delivers positive patient experience.
• Cooperates with and maintains excellent working relationships with patients, AHN leadership and staff, physician offices and designated external agencies or vendors.
• Performs any written or verbal communication necessary to exchange information with designated contacts and promote working relationships.
• Maintains focus on attaining productivity standards, recommending new approaches for enhancing performance and productivity when appropriate.
• Adheres to AHN organizational policies and procedures for relevant location and job scope.
• Completes and/orattends mandatory training and education sessions within approved organizational guidelines and timeframes.
• Communicates team barriers, process flow or productivity issues to team lead. Assists team members with operational support and training
• Assists in resolving patient issues requiring additional oversight in a concise and informative manner as required.
• Performs other duties as assigned or required.

Licensure/Certification/ Registration:

• Works under minimal supervision. Performs duties in accordance with departmental guidelines. Seeks direction for issues outside of guidelines. Clear understanding of the impact pre-registration services has on Revenue Cycle operations and financial performance. Excellent written, verbal communication and interpersonal skills. Ability to prioritize and manage multiple tasks simultaneously, and to effectively anticipate and respond to issues as needed in a dynamic work environment. A demonstrated ability to use PC based office productivity tools (e.g. Microsoft Outlook, Microsoft Excel) as necessary; general computer skills necessary to work effectively in an office environment. Dedication to treating both internal and external constituents as clients and customers, maintaining a flexible customer service approach and orientation that emphasizes service satisfaction and quality

Requirements:

• High School diploma or GED required.
• A minimum of two (2) previous years of related healthcare Revenue Cycle experience, preferably within a financial clearance setting required.
• Experience operating PC and using software applications required.
• Excellent customer service and communication skills.

Preferred:

• Associates degree preferred.
• Certification with Healthcare Financial Management Association or Certified Revenue Cycle Representative preferred.
• Three (3) years experience preferred.
• Call center experience preferred.