Patient Access Specialist-Per Diem-Day

2 weeks ago

Holmdel, New Jersey, United States Hackensack Meridian Health Full time
Job Title: Patient Access Specialist-Per Diem-Day

Job Summary:

We are seeking a highly skilled Patient Access Specialist to join our team at Hackensack Meridian Health. As a Patient Access Specialist, you will be responsible for ensuring the smooth and efficient flow of patients through our medical center. This includes conducting quality interviews with patients, gathering identification and demographic information, and verifying insurance coverage.

Key Responsibilities:

  • Conduct quality interviews with patients to ensure compliance with patient safety rules and state and federal regulations.
  • Gather identification and demographic information for patients.
  • Verify insurance coverage and benefits for patients.
  • Perform job-related functions, including facility-based scheduling, bed planning, pre-registration, registration, insurance verification, pre-certification, point of service cash collection, and financial clearance.
  • Ensure accurate completion of Medicare Secondary Payer Questionnaire.
  • Verify benefits to ensure the procedure is a covered service under the patient's plan prior to receiving services.
  • Verify pre-authorization requirements and follow up with both the referring physician's office and payer to ensure authorizations are on file for the scheduled procedure prior to the date of service.
  • Submits all data timely, effectively, and expeditiously for all treatments and procedures to ensure authorizations have been obtained and determine that the procedure or treatment is authorized prior to the date of service.
  • Ensures diagnosis data that is entered on registration is accurate and meets medical necessity criteria.
  • Complies with HMH's patient financial responsibility and collection policies.
  • Provides patients with appropriate administrative information, as directed.
  • Maintains compliance with federal/state requirements and ensures signatures are obtained on all required regulatory/consent forms.
  • Manually registers patients accurately when in 'downtime' mode and properly follows registration input procedures when the system becomes available.
  • Attempts to mediate daily scheduling, pre-registration, pre-certification, or registration issues and elevates any issues that cannot be resolved independently.
  • Completes assigned work queue (WQ) accounts in a timely and efficient manner.
  • Assumes other responsibilities as directed by either the Supervisor, Manager, or Director of Patient Access.
  • Identifies the needs of the patient population served and modifies and delivers care that is specific to those needs.
  • Ensures delivery of excellent customer service resulting in a positive patient experience.
  • Complies with all procedural workflows and departmental policies and procedures as identified.
  • Responsible for scanning any documents and correspondence from patients and payers.
  • Coordinates daily activities of the Patient Access Department which fosters an environment promoting patient comfort and trust.
  • Has the ability to schedule patients as needed.
  • Answers a high volume number of phone calls and responds in an appropriate/professional manner. Address and resolve any issues quickly/accurately.
  • Ensures timely notification of admission to payers and refers accounts to Case Management for timely submission of Clinical Information to payer.
  • Verifies eligibility and benefits to ensure patient's coverage is active and that the procedure is a covered service under the patient's plan prior to the date of service.
  • Verifies pre-authorization requirements and follows up with both the referring physician's office and payer to ensure authorizations are on file for the scheduled procedure prior to the date of service.
  • Able to access and navigate various payer websites (e.g. Navinet) to confirm patients' insurance coverage and policy benefits.
  • Works with patients to financially clear their account per policy at least 3 days prior to procedure. Resolves any issues with coverage and escalates any complications to supervisor/manager. Makes referrals to Financial Counselors if appropriate.
  • Accurate and timely processing of all methods of acceptable payments such as cash/check/money order/credit card transactions. Reconciling daily cash drawer or shift payment transactions, depositing daily cash/check and providing patients with cash receipts, and/or service estimate.
  • Completes a pre-registration on all appropriate patients in Epic. Able to clear a checklist in Epic and set an account status to 'Confirmed pre-reg.'
  • Contacts patients and/or physicians' offices in regards to Pre-Admission Testing scheduling in a timely and efficient manner.
  • Obtains patient records, types and processes scheduling information included but not limited to copying, filing, faxing and answering phone calls in an accurate, efficient and professional manner.
  • Can work in all Access Services areas within the hospital and may rotate shifts as needed.
  • Checks email daily to maintain timely updates on any process/task changes/updates.
  • Meet departmental daily productivity and process standards.
  • Other duties and/or projects as assigned.
  • Adheres to HMH Organizational competencies and standards of behavior.

Requirements:

  • High School diploma, general equivalency diploma (GED), and/or GED equivalent programs.
  • Ability to work rotating schedules/shifts based on needs.
  • Good written and verbal communication skills.
  • Customer Service Oriented.
  • Basic medical terminology knowledge.
  • Proficient computer skills that may include but are not limited to Microsoft Office and/or Google Suite platforms.
  • Ability to work every other weekend.
  • Ability to work three (3) out of six (6) holidays.

Preferred Qualifications:

  • Bachelor's Degree and/or related experience.
  • Minimum of 1+ years of experience in a hospital setting.
  • Patient Financial services experience in a professional or hospital setting.
  • Prior registration/insurance verification experience.
  • Excellent Analytical, written and verbal communication, and interpersonal skills.
  • Proficient medical terminology knowledge.
  • Knowledge of insurance specifications, ICD10 and CPT4 codes.
  • Bilingual (i.e. Spanish or Korean).
  • Experience with EPIC HB, Cadence, and Prelude.

Licenses and Certifications Required:

  • Successfully complete EPIC Cadence and Prelude training and pass assessment that follows within 30 days after Network access is granted.

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