Patient Access Specialist

Hackensack Meridian Health•Neptune Township, NJ

13d•$26•Onsite

About The Position

The Patient Access Specialist performs inpatient and outpatient patient access functions within the Patient Access Services Department in assigned areas or hospitals. The role conducts patient interviews, verifies identity and demographics, screens insurance coverage, obtains required consents and attestations, and supports scheduling, bed planning, pre-registration, registration, insurance verification, pre-certification, point-of-service collections, and financial clearance. The specialist works under the direction of a Patient Access Supervisor, Manager, or Director and follows medical center quality standards, regulatory requirements, and departmental workflows while maintaining a positive patient experience. The position supports patients and their families throughout access and financial clearance processes, including communicating coverage and out-of-pocket responsibilities, resolving or escalating registration and authorization issues, and directing patients to financial resources when appropriate. It requires accurate and timely processing of patient information, payments, and documentation, as well as coordination with physicians' offices, payers, Case Management, and other hospital teams. The specialist may work in different Access Services areas and rotate shifts based on departmental needs.

Requirements

High school diploma, GED, or GED-equivalent program.
Ability to work rotating schedules or shifts based on departmental needs.
Ability to work every other weekend.
Ability to work three out of six holidays.
Good written and verbal communication skills.
Customer-service orientation.
Basic knowledge of medical terminology.
Proficient computer skills, which may include Microsoft Office and/or Google Suite.
Successfully complete EPIC Cadence and Prelude training and pass the assessment within 30 days after Network access is granted.
Ability to lift at least 20 lbs., push and pull at least 300 lbs., and stand at least four hours per day.

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 knowledge of medical terminology.
Knowledge of insurance specifications and ICD-10 and CPT-4 codes.
Bilingual skills, 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, provide appropriate administrative information, and deliver excellent customer service.
Implement scheduling, pre-registration, pre-certification, referral procurement, and insurance verification policies and procedures.
Follow patient identification policy, perform accurate patient searches, and prevent duplicate medical record numbers.
Check in patients and account for their location and arrival or processing time to support prompt service within departmental guidelines.
Ensure regulatory forms and consent forms are completed and signed, and maintain compliance with federal and state requirements.
Perform bed planning functions, including reservations, pre-registration, bed assignment, prioritization, appropriate unit placement, and review of patient status and level-of-care orders.
Initiate 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, confirm active coverage and covered services, and determine patients' out-of-pocket responsibility using the EPIC Financial Estimator.
Explain patient financial responsibilities and available financial resources, collect payments when appropriate, and comply with patient financial responsibility and collection policies.
Verify pre-authorization requirements and follow up with referring physicians' offices and payers to ensure authorizations are obtained before scheduled services.
Submit treatment and procedure information in a timely manner, ensure diagnosis data is accurate and meets medical necessity criteria, and notify payers of admissions as required.
Work with patients to financially clear accounts at least three days before procedures, resolve coverage issues, escalate complications, and refer patients to Financial Counselors when appropriate.
Process accepted payment methods accurately and on time; reconcile daily cash drawers or shift transactions, deposit cash and checks, and provide receipts or service estimates.
Complete appropriate pre-registrations in Epic, clear Epic checklists, and set account status to Confirmed pre-reg.
Contact patients and physicians' offices about Pre-Admission Testing scheduling and obtain, type, and process scheduling records and information.
Manually register patients during system downtime and follow registration input procedures when systems become available.
Resolve daily scheduling, pre-registration, pre-certification, and registration issues when possible, escalating issues that cannot be resolved independently.
Complete assigned work queue accounts and meet departmental productivity and process standards.
Scan documents and correspondence from patients and payers, and perform related copying, filing, and faxing.
Answer a high volume of phone calls professionally and address issues quickly and accurately.
Coordinate daily Patient Access Department activities to promote patient comfort and trust, and schedule patients as needed.
Adapt communication and service to the needs of the patient population, including age, culture, language, hearing, visual, developmental, educational, and literacy needs.
Check email daily for process and task updates, adhere to organizational competencies and standards of behavior, and perform other duties or projects as assigned.
Work in all Access Services areas within the hospital and rotate shifts as needed.