Patient Access Analyst
3 weeks ago
Overview:
Our team members are the heart of what makes us better.
At **Hackensack Meridian **_Health_** we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community.
Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.
The** Patient Access Analyst** is a revenue cycle expert in the areas of scheduling, registration, referrals, and Inpatient and Outpatient authorization/denials management in their assigned area/hospital(s) at Hackensack Meridian Health (HMH). Responsible for researching and analyzing denials. Identifies root cause, trends and patterns and provides feedback to management for future education to the end users. Performs reviews of all Access data elements, such as real time eligibility (RTE), Medicare Payer Secondary Questionnaire (MSPQ), Insurance plan codes, proper sequencing of COB (Coordination of Benefits), and reviews physician licensure. Works with Access assigned Work Ques (WQs) to correct the edits causing the stop bills. Included in this is the compilation of edit findings to provide management with a tool to provide education, increase the overall number of clean claims, and decrease the rework necessary to generate clean claims. Performs validation checks if the National Provider Identifier (NPI) number is not available or not entered by Patient Access Specialist at time of registration to again mitigate loss of revenue and ensure timely billing standards are met as specified by certain payors.
**Responsibilities**:
A day in the life of a **Patient Access Analyst at Hackensack** Meridian _Health_ includes:
- Navigate to the corresponding State License Verification website based on the state in which the provider is licensed, and search for the provider's license status using the provider's License # or name.
- If an exclusion is identified, the Analyst will place bills on hold and work collectively to mitigate issues.
- Perform reviews of Registration billing accuracy and timely filing of claims to various insurance payers as well as review of various Discharged/Not Billed (DNB) EPIC registration work queues where bills have been held up due to various registration errors (Physician not on staff, Insurance not active on date of service, patient not found in payor website, accuracy of Coordination of Benefits, registration service type missing, and others) as identified by Access Management.
- Identify and provide trends and patterns, and present these findings to Access Services Management.
- Assists with the resolution of the billing system and edit issues as they arise. Keeps Manager informed of all system issues and consults for direction as necessary.
- Evaluates actual versus planned performance and metrics, presents and communicates possible opportunities.
- Identifies and suggests resolution for problems involving departments which affect registration productivity and or data quality and compliance.
- Maintains accurate notes and electronic documentation of findings; documents requirements, expectations and/or deadlines to ensure accurate and timely completion of tasks.
- Complies with all procedural workflows and departmental policies and procedures as identified.
- Assumes other responsibilities as directed by either the Supervisor, Manager, or Director.
- Other duties and/or projects as assigned.
- Adheres to HMH Organizational competencies and standards of behavior.
Qualifications:
**Education, Knowledge, Skills and Abilities Required**:
- Associate's Degree or equivalent relevant HMH experience.
- Minimum 5 years of prior experience in hospital access management, or a large health insurer approval process.
- Excellent analytical and critical thinking skills.
- Ability to work in a fast paced environment, coordinating multiple projects and deadlines or changing priorities.
- Strong attention to and recall for details.
- Prior experience in an Access Services Department.
- Must be highly organized and possess excellent time management skills.
- Strong written and verbal communication skills.
**Education, Knowledge, Skills and Abilities Preferred**:
- Bachelor's Degree.
- Experience with EPIC.
- Prior experience in an Access Services Department.
- Excellent analytical and critical thinking skills.
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