Company :Allegheny Health Network
Job Description :
Coordinates financial activities and provides customer support. Assists with coordination of day-to-day operations.
- Counsels patients and families regarding insurance coverage, medical policy and all other aspects related to the financial and billing process. Assists patients regarding alternate funding agencies and resources. (20%)
- Collects payments and reconciles accounts according to established fee schedules. (20%)
- Negotiates with external agencies, insurance carriers, providers, patients, etc for information/documentation, payment settlements, authorization issues, and resolution of benefit issues. (20%)
- Monitors outstanding accounts and informs management of backlog issues. Resolves and addresses issues and deficiencies related to reimbursement and denials. Notifies management of any barriers effecting reimbursement. (10%)
- Provides analytical support for identification and notification of trends, and regulatory changes. (10%)
- Provides staff resources or technical guidance and problem resolution related to insurance verification, billing, collections, and financial counseling processes. Supports in training new members of PFS team. (10%)
- Identifies work flow issues such as duplication of efforts, need for automation of manual processes, need for written work flow procedures, failure to utilize existing computerized system capabilities. Provides continuous quality improvement through system analysis, making recommendations, and implementing work flow changes. (10%)
- Performs other duties as assigned or required.
- Associate’s Degree or equivalent from a two-year college or technical school; or 3-5 years’ coordinator experience and/or training; or equivalent combination of education and experience.
- 3-5 years’ experience performing collections, benefits verification, and customer service.
- Bachelor’s Degree.
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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