Patient Access Specialist - Part Time - Day

Hackensack Meridian Health•Neptune Township, NJ

23d•$26

About The Position

The Patient Access Specialist performs inpatient and outpatient patient access functions within Hackensack Meridian Health’s Patient Access Services Department in an assigned area or hospital. The role conducts patient interviews, confirms identity and demographic information, obtains required consents, and screens Medicare, Medicaid, and managed-care patients for network status and coordination of benefits. Functions may include scheduling, bed planning, pre-registration, registration, insurance verification, pre-certification, point-of-service collections, and financial clearance. The specialist follows the Medical Center’s quality standards, regulatory requirements, departmental policies, and customer-service expectations to support patient safety and a positive patient experience. The position handles patient and payer communications, verifies eligibility and benefits, coordinates authorization and admission-notification processes, processes payments, and resolves or escalates access and coverage issues. The specialist may work in different Access Services areas and rotate shifts as needed. The position requires working every other weekend and three of six holidays, and includes physical requirements for lifting, pushing, pulling, and standing.

Requirements

High school diploma, GED, or GED-equivalent program.
Ability to work rotating schedules or shifts based on operational needs.
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.
Ability to work every other weekend.
Ability to work three out of six holidays.
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 knowledge of medical terminology.
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.
Apply scheduling, pre-registration, pre-certification, referral, and insurance-verification procedures for assigned outpatient services.
Follow patient-identification procedures, perform accurate patient searches, and help prevent duplicate medical record numbers.
Check patients in and track their location and arrival or processing time to support timely service.
Ensure regulatory and consent forms are completed and signed.
Perform bed-planning functions, including reservations, pre-registration, and bed assignment; prioritize assignments and ensure patients are placed in the appropriate unit and level of care.
Review orders to confirm the appropriate patient status and level of care.
Run and review real-time eligibility queries, verify insurance coverage and benefits, and ensure correct plan-code assignment and coordination of benefits.
Complete Medicare Secondary Payer Questionnaires and perform insurance verification for inpatient and outpatient services.
Use the EPIC Financial Estimator to determine patient out-of-pocket responsibility and explain financial responsibilities and available financial resources.
Collect and process acceptable payments, reconcile daily cash or shift transactions, deposit cash and checks, and provide receipts or service estimates.
Verify coverage and pre-authorization requirements, follow up with referring physicians and payers, and submit information in time to secure authorization before the service date.
Ensure registration diagnosis data is accurate and meets medical-necessity criteria.
Comply with patient financial responsibility, collection, regulatory, and consent-form requirements.
Register patients manually during system downtime and follow registration procedures when systems return.
Resolve daily scheduling, pre-registration, pre-certification, and registration issues where possible, and escalate issues that cannot be independently resolved.
Complete assigned work-queue accounts and Epic pre-registration checklists accurately and promptly.
Notify payers of admissions in a timely manner and refer accounts to Case Management for clinical information submission.
Work with patients to financially clear accounts at least three days before procedures, resolve coverage issues, and refer patients to Financial Counselors when appropriate.
Contact patients and physicians’ offices regarding Pre-Admission Testing scheduling.
Obtain, scan, and process patient records and correspondence, including copying, filing, faxing, and handling phone calls.
Answer a high volume of calls professionally and address issues promptly and accurately.
Adapt communication and services to patients’ age, culture, language, hearing, vision, developmental, educational, and literacy needs.
Coordinate daily Patient Access Department activities that promote patient comfort and trust, and deliver excellent customer service.
Schedule patients as needed, work in Access Services areas across the hospital, and rotate shifts as required.
Check email daily for process and task updates and meet departmental productivity and process standards.
Perform other duties and projects as assigned and adhere to HMH organizational competencies and standards of behavior.
Lift at least 20 pounds, push and pull at least 300 pounds, and stand at least four hours per day.