Health Access Specialist - FT - Day - Patient Access Services Hamilton NJ

Capital Health (US)•Hamilton, OH

1d•$19 - $23•Onsite

About The Position

Demonstrates service excellence by professionally assisting patients and customers with the utmost respect in a friendly caring manner. Follows all payor requirements, and identifies needs for referrals and precertification. Performs verification of benefits on all patient encounters. Audits chart for accuracy. Follows computer system, internet based insurance applications, and department operational procedures and training guidelines to obtain accurate demographic, diagnosis, authorizations/referrals and insurance information on each registration. Works collaboratively with other departments, physicians, physician office staff to obtain essential registration information such as insurance authorization, referrals, diagnosis’s, and scripts, to secure financial reimbursement and customer/patient satisfaction. Complies with department procedures and regulatory guidelines for Medicare Secondary Payer, Medicare Necessity Regulations, Collection of co-pay/deposit, Advance Beneficiary Notice, Advance Directives, and Patients Rights. Registers established goal of minimum required patients per employee shift as measured by productivity reports. Correctly identifies a patient according to policy, completes all patient registration types by collecting and entering accurate patient demographics, physician information, insurance information and valid category codes. Ascertains and records appropriately the difference between patients primary care, referring physician and attending physician. Obtains all necessary signatures. Assures insurance information is verified and authorization is obtained if not done prior to service, essential registration forms are scanned into Alpha, and chart follow up is performed as needed. Ascertains and records appropriately the difference between primary care physician, referring physician and attending physician. Expert in participating CH insurance plans and the ability to identify non participating plans. Follows payer requirements for authorization, pre-authorization, referrals, coordination of benefits forms, and in-network verification according to department procedures and the Insurance Card Database and Insurance Verification guidelines. Performs verification of benefits either electronically or by telephone according to department procedures and guidelines. Identifies and obtains required precertification, authorizations and/or referrals and audits all information in the appropriate registration and billing system. Follows Financial Screening and Self Pay Procedure with regards to referrals for Medicaid and Charity Care. Makes appropriate referrals to Medicaid, Medicare and Charity for patients determined to be under insured or uninsured. Completes PE Medicaid and FD80 forms for maternity patients. Attends all mandatory department meetings. Supports department performance improvement initiatives.

Requirements

High school diploma or GED.
Six months in a Health Access Rep role at Capital Health required.
One year experience in a healthcare setting or one year customer service experience with medical terminology and basic computer skills required.
Excellent communication, interpersonal and organizational skills.
Ability to problem solve and multitask and manage frequent interruptions.
Expert and current knowledge of all aspects of insurance requirements.
Proficient computer skills.
Familiar with medical terminology.
Ability to handle a stressful environment.

Nice To Haves

A quality of knowledge of insurance plans and insurance experience preferred.

Responsibilities

Assist patients and customers with respect in a friendly caring manner.
Follow all payor requirements, identify needs for referrals and precertification.
Perform verification of benefits on all patient encounters.
Audit chart for accuracy.
Obtain accurate demographic, diagnosis, authorizations/referrals and insurance information on each registration using computer systems and internet-based insurance applications.
Collaborate with other departments, physicians, and physician office staff to obtain essential registration information.
Comply with department procedures and regulatory guidelines for Medicare Secondary Payer, Medicare Necessity Regulations, Collection of co-pay/deposit, Advance Beneficiary Notice, Advance Directives, and Patients Rights.
Register patients, collecting and entering accurate demographic, physician, and insurance information.
Identify and record the difference between patients primary care, referring physician, and attending physician.
Obtain all necessary signatures.
Verify insurance information and obtain authorization if not done prior to service.
Scan essential registration forms into Alpha and perform chart follow-up as needed.
Identify participating and non-participating CH insurance plans.
Follow payer requirements for authorization, pre-authorization, referrals, coordination of benefits forms, and in-network verification.
Perform verification of benefits electronically or by telephone.
Identify and obtain required precertification, authorizations, and/or referrals.
Audit all information in the appropriate registration and billing system.
Follow Financial Screening and Self Pay Procedure for referrals to Medicaid and Charity Care.
Make appropriate referrals to Medicaid, Medicare, and Charity for under-insured or uninsured patients.
Complete PE Medicaid and FD80 forms for maternity patients.
Attend all mandatory department meetings.
Support department performance improvement initiatives.