Patient Access Specialist - Full Time - Day

Hackensack Meridian Health•Neptune Township, NJ

5d•$26•Onsite

About The Position

The Patient Access Specialist performs inpatient and outpatient patient access functions within the Patient Access Services Department at an assigned Hackensack Meridian Health area or hospital. The role conducts patient interviews, verifies identity and demographics, screens insurance coverage and coordination of benefits, obtains required consents, and supports scheduling, bed planning, pre-registration, registration, insurance verification, pre-certification, point-of-service collections, and financial clearance. The specialist follows patient safety, regulatory, quality, and departmental requirements while maintaining a positive patient experience. The stated shift is 3:00 p.m. to 1:30 a.m., with work required every other weekend and three of six holidays. The position may work across Access Services areas within the hospital and rotate shifts as needed.

Requirements

High school diploma, GED, or equivalent program.
Ability to work rotating schedules or shifts based on departmental needs.
Ability to work every other weekend.
Ability to work three of six holidays.
Good written and verbal communication skills.
Customer-service orientation.
Basic knowledge of medical terminology.
Proficient computer skills, including Microsoft Office and/or Google Suite platforms.
Successfully complete EPIC Cadence and Prelude training and pass the associated 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 patient registration or insurance verification experience.
Excellent analytical, written and verbal communication, and interpersonal skills.
Proficient medical terminology knowledge.
Knowledge of insurance specifications, 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.
Carry out scheduling, pre-registration, pre-certification, referral procurement, and insurance verification procedures for assigned outpatient points of service.
Follow patient identification policies and conduct accurate patient searches to support patient safety and prevent duplicate medical records.
Check in patients and track their arrival, location, and processing time to support timely service.
Ensure regulatory and consent forms are completed and signed.
Perform bed planning, reservations, pre-registration, and bed assignments; prioritize assignments according to policy and confirm the appropriate unit and level of care.
Initiate and review real-time eligibility queries, confirm plan codes and coordination of benefits, and complete Medicare Secondary Payer Questionnaires.
Verify insurance for inpatient and outpatient services, benefits, eligibility, and pre-authorization requirements; follow up with referring physician offices and payers to obtain required authorizations before services.
Use the EPIC Financial Estimator to determine patients' out-of-pocket responsibility and pursue appropriate upfront collections.
Explain financial responsibilities and available resources, including financial assistance and payment plans, and accept and process approved payment methods.
Ensure diagnosis information entered during registration is accurate and meets medical necessity criteria.
Submit treatment and procedure information promptly to support authorization and timely reimbursement, and notify payers of admissions as required.
Refer accounts to Case Management for timely submission of clinical information and refer patients to Financial Counselors when appropriate.
Work with patients to financially clear accounts according to policy at least three days before procedures and escalate coverage complications.
Manually register patients during system downtime and follow registration procedures when systems become available.
Resolve scheduling, pre-registration, pre-certification, and registration issues when possible and escalate unresolved issues.
Complete assigned work queue accounts and meet departmental productivity and process standards.
Scan patient and payer documents and correspondence; obtain, type, and process patient records and scheduling information.
Contact patients and physician offices regarding Pre-Admission Testing scheduling.
Schedule patients as needed, handle a high volume of phone calls professionally, and address issues promptly and accurately.
Reconcile shift payment transactions, deposit cash and checks, and provide receipts and service estimates as applicable.
Adapt communication and service to the needs of patients and caregivers, including age, culture, language, literacy, hearing, and vision needs.
Coordinate daily department activities in a manner that promotes patient comfort and trust.
Check email daily for process and task updates and comply with workflows, policies, organizational competencies, and standards of behavior.
Work in Access Services areas throughout the hospital and rotate shifts as needed; perform other assigned duties or projects.