Patient Access Specialist-FT-Evening

Hackensack Meridian Health - Neptune City, NJ

Full-time - Entry Level

Neptune City, NJ

Hospitals

About the position

The Patient Access Specialist plays a crucial role in the Patient Access Services Department at Hackensack Meridian Health, responsible for managing all inpatient and outpatient patient access functions. This position involves conducting quality interviews with patients, ensuring compliance with safety rules and regulations, and gathering necessary patient information. The specialist will also handle scheduling, registration, insurance verification, and financial clearance, all while maintaining a positive patient experience and adhering to quality standards.

Responsibilities

• Greets patients and visitors in person/phone in a prompt, courteous, respectful and helpful manner.
• Implements scheduling, pre-registration, pre-certification, referral procurement and insurance verification policies and procedures for the assigned outpatient point of service.
• Adheres to patient identification policy and ensures an accurate patient search is performed to maintain patient safety.
• Checks in and accounts for the location and arrival/processing time of patients to ensure prompt service.
• Ensures Regulatory Forms are filled out and signed by the patient.
• Performs all functions of bed planning; reservations/pre-registration/bed assignment.
• Prioritizes bed assignment in accordance with policy.
• Ensures patients are assigned to the proper unit according to admit order.
• Reviews orders to ensure patient is in appropriate status and level of care.
• Initiates real-time eligibility query (RTE) on all eligible insurances and reviews RTE response for correct plan code assignment.
• Performs insurance verification on all inpatient and outpatient services, determining the patient's out-of-pocket responsibility.
• Pursues upfront cash collections to assist patients in understanding their financial responsibilities.
• Informs patients of their out-of-pocket responsibility and explains financial resources.
• Verifies benefits to ensure the procedure is a covered service under the patient's plan prior to receiving services.
• Verifies pre-authorization requirements and follows up with both the referring physician and payer to ensure authorizations are on file.
• Submits all data timely for all treatments and procedures to ensure authorizations have been obtained.
• Ensures diagnosis data entered on registration is accurate and meets medical necessity criteria.
• Complies with HMH's patient financial responsibility and collection policies.
• Provides patients with appropriate administrative information as directed.
• Maintains compliance with federal/state requirements and ensures signatures are obtained on all required forms.
• Manually registers patients accurately when in 'downtime' mode and follows registration input procedures when the system is available.
• Attempts to mediate daily scheduling, pre-registration, pre-certification or registration issues and elevates unresolved issues.
• Completes assigned work queue accounts in a timely manner.
• Identifies the needs of the patient population served and modifies care delivery accordingly.
• Ensures delivery of excellent customer service resulting in a positive patient experience.
• Responsible for scanning any documents and correspondence from patients and payers.
• Coordinates daily activities of the Patient Access Department to promote patient comfort and trust.
• Answers a high volume of phone calls and responds professionally.
• Ensures timely notification of admission to payers and refers accounts to Case Management for timely submission of Clinical Information.
• Verifies eligibility and benefits to ensure patient's coverage is active prior to the date of service.
• Able to access and navigate various payer websites to confirm patients' insurance coverage.
• Works with patients to financially clear their account per policy at least 3 days prior to procedure.
• Resolves any issues with coverage and escalates complications to supervisor/manager.
• Accurate and timely processing of all methods of acceptable payments and reconciling daily cash drawer.
• Completes a pre-registration on all appropriate patients in Epic.
• Contacts patients and/or physicians' offices regarding Pre-Admission Testing scheduling.
• Obtains patient records and processes scheduling information accurately and efficiently.
• Can work in all Access Services areas within the hospital and may rotate shifts as needed.
• Checks email daily for updates on any process/task changes.
• Meets departmental daily productivity and process standards.

Requirements

• High School diploma or GED required.
• Ability to work rotating schedules/shifts based on needs.
• Good written and verbal communication skills.
• Customer service oriented.
• Basic medical terminology knowledge.
• Proficient computer skills, including Microsoft Office and/or Google Suite.

Nice-to-haves

• Bachelor's Degree and/or related experience preferred.
• Minimum of 1+ years of experience in a hospital setting preferred.
• Patient Financial services experience in a professional or hospital setting preferred.
• Prior registration/insurance verification experience preferred.
• Excellent analytical, written and verbal communication, and interpersonal skills preferred.
• Knowledge of insurance specifications, ICD10 and CPT4 codes preferred.
• Bilingual (i.e. Spanish or Korean) preferred.
• Experience with EPIC HB, Cadence, and Prelude preferred.

Benefits

• Employee discount
• Tuition reimbursement