Allegheny Health Network Careers

Job No: D-PATACOOR
Department: Medical Records
Locations: Allegheny General Hospital,  Allegheny Center, Canonsburg, West Penn Hospital, Wexford Health and Wellness Pavilion, and a System Float (Float position based at Allegheny General with travel to Peters Twp., Mt. Lebanon, Bloomfied, Monroeville, and Wexford on an as needed basis)
Status: Full-Time, Part-time, and Casual

Shifts: 1st, 2nd, 3rd (can include weekends and holidays)

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 17,000 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.

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.

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/or attends mandatory training and education sessions within approved organizational guidelines and timeframes.
• Performs other duties as assigned or required.

Required Qualifications:

• High School diploma or GED required.
• 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
• 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.

Preferred Qualifications:

• Associates degree preferred.
• Certification with Healthcare Financial Management Association or Certified Revenue Cycle Representative preferred.