Patient Access Specialist - Per Diem - Night

Hackensack Meridian Health•North Bergen, NJ

11d•$27•Onsite

About The Position

The Patient Access Specialist performs inpatient and outpatient patient-access functions in an assigned area or hospital within Hackensack Meridian Health’s Patient Access Services Department. The role conducts patient interviews to support patient safety and regulatory compliance, verifies patient identity and demographics, screens insurance coverage and coordination of benefits, obtains required consents, and carries out scheduling, bed planning, pre-registration, registration, insurance verification, pre-certification, point-of-service collections, and financial clearance under the direction of a Supervisor, Manager, or Director. The specialist follows Medical Center quality standards and supports a positive patient experience. The position works across Patient Access areas as needed and may rotate shifts. It involves frequent interaction with patients, visitors, physicians’ offices, payers, and internal teams; timely processing of registrations, authorizations, payments, and work queue accounts; and accurate use of Epic and payer systems. The role also supports bed assignments, pre-admission testing scheduling, scanning and processing documents, and resolution or escalation of access and coverage issues.

Requirements

High school diploma, GED, or equivalent program.
Ability to work rotating schedules and shifts based on operational needs.
Good written and verbal communication skills.
Customer-service orientation.
Basic medical terminology knowledge.
Proficient computer skills, which may include Microsoft Office and/or Google Suite.
Ability to work every other weekend.
Ability to work three out of six holidays.
Successfully complete EPIC Cadence and Prelude training and pass the assessment within 30 days after Network access is granted.

Nice To Haves

Bachelor’s degree and/or related experience.
At least one year of experience in a hospital setting.
Patient financial services experience in a professional or hospital setting.
Prior registration or insurance-verification experience.
Excellent analytical, written and verbal communication, and interpersonal skills.
Proficient medical terminology knowledge.
Knowledge of insurance specifications and ICD-10 and CPT-4 codes.
Bilingual ability, such as Spanish or Korean.
Experience with EPIC HB, Cadence, and Prelude.

Responsibilities

Greet patients and visitors promptly and courteously in person and by phone, and provide appropriate administrative information.
Apply scheduling, pre-registration, pre-certification, referral, and insurance-verification policies for assigned outpatient services.
Follow patient-identification procedures and perform accurate patient searches to protect patient safety and prevent duplicate medical record numbers.
Track patient arrival and processing times and support prompt service within departmental guidelines.
Ensure regulatory and consent forms are completed and signed, and comply with applicable federal and state requirements.
Perform bed-planning functions, including reservations, pre-registration, bed assignment, prioritization, and assignment to the appropriate unit based on the admit order.
Review orders to confirm the patient’s status and level of care are appropriate.
Run real-time eligibility queries, review responses, assign correct plan codes, coordinate benefits, and complete Medicare Secondary Payer Questionnaires accurately.
Verify insurance for inpatient and outpatient services, benefits, coverage, and pre-authorization requirements; follow up with referring physicians and payers to secure authorizations before services.
Use the EPIC Financial Estimator to determine patient out-of-pocket responsibility and pursue appropriate upfront collections in accordance with policy.
Explain financial responsibilities and available resources, including financial assistance and payment plans; refer patients to Financial Counselors when appropriate.
Submit treatment and procedure information promptly to support authorization and reimbursement, and ensure registration diagnosis data is accurate and meets medical-necessity criteria.
Comply with patient financial responsibility and collection policies.
Manually register patients during system downtime and follow registration input procedures when systems become available.
Resolve routine scheduling, pre-registration, pre-certification, and registration issues, escalating unresolved issues to a supervisor or manager.
Complete assigned work queue accounts accurately and on time.
Identify patient population needs and adapt communication and service to patients’ age, culture, language, literacy, hearing, or visual needs.
Provide excellent customer service and contribute to patient comfort and trust.
Scan patient and payer documents and correspondence, and process patient records and scheduling information, including copying, filing, and faxing.
Coordinate daily Patient Access activities and schedule patients as needed.
Answer a high volume of phone calls professionally and resolve issues promptly and accurately.
Notify payers of admissions on time and refer accounts to Case Management for timely submission of clinical information.
Financially clear accounts at least three days before procedures, resolve coverage issues, and escalate complications as needed.
Process accepted payments accurately, reconcile daily cash drawers or shift transactions, deposit cash and checks, and provide receipts or service estimates.
Complete appropriate Epic pre-registrations, clear Epic checklists, and set account status to Confirmed pre-reg.
Contact patients and physicians’ offices regarding Pre-Admission Testing scheduling.
Access and navigate payer websites, such as Navinet, to confirm insurance coverage and policy benefits.
Work in all Access Services areas within the hospital and rotate shifts as needed.
Check email daily for process and task updates, meet departmental productivity and process standards, and perform other assigned duties or projects.
Adhere to HMH organizational competencies, standards of behavior, procedural workflows, and departmental policies.