HEALTHCARE ACCESS SPECIALIST

About Us

At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development. Discover why Cooper University Health Care is the employer of choice in South Jersey.

About the Role

The HCA Patient Access Specialist communicates with insurance companies, patients, and healthcare providers to resolve discrepancies, update records, and ensure proper billing. Accuracy is crucial to prevent claim denials and facilitate smooth reimbursement processes. This role requires attention to detail, strong organizational skills, knowledge of insurance policies, sense of urgency to meet time-sensitive insurance requirements, and effective communication skills to navigate the complexities of healthcare billing.

Responsibilities

• Ensure quality patient registration, validation, and verification of insurance information.
• Collect and review all patient insurance information needed to complete the benefit verification process.
• Investigate missing data needed to complete the verification process.
• Troubleshoot and seek solutions to problems related to questions and concerns over health insurance coverage.
• Coordinate benefits and complete MSPQ episodically to ensure proper coordination for Medicare recipients.
• Perform point of service collections, maintain positive telephone etiquette, and support patient satisfaction in alignment with Cooper University Hospital Mission and Core Values.
• Work independently and as a team with an enthusiastic personality.
• Apply knowledge of state and federal government funding programs such as Medicare, Medicaid, and requirements to satisfy timely notification of rights as it pertains to these programs.
• Secure and deliver proper correspondence needed to satisfy requirements such as CMS IMM, CMS MOON, NJ Observation, and CMS NSA forms.
• Use all modes of electronic insurance verification, RTE, portals such as NaviNet, Availity, PEAR, Notivasphere, insurance verification websites as well as telephonic verification as needed.
• When appropriate, ensure the payer receives a Notice of Admission on all admissions, scheduled and non-scheduled, within 24 hours or the next business day.
• Submit notice of admissions to all payors via electronic portal or fax transmittal as appropriate and timely.
• Communicate as appropriate with the physicians, NJ Medical Examiners, the Sharing Network, and Funeral Directors to ensure timely handling of deceased patients.
• Initiate electronic death record via NJ EDRS.

Experience

• 2 years required; 3-5 years preferred.
• Preferred experience includes:
  • Minimum one year of registration or billing experience working in a medical facility.
  • Proficiency in patient registration, scheduling, medical insurance pre-certifications, authorizations, and referrals.
  • Epic experience preferred.

Education

• High School Diploma or Equivalent required.

License/Certification

• NAHAM Certified Healthcare Access Associate (CHAA) certification or HFMA Certified Revenue Cycle certification (Preferred).

Skills

• Excellent verbal and written communications skills.
• Experienced in use of computers and software applications, i.e., Microsoft Word, Excel, Outlook, Access, registration, and billing systems.
• Exceptional customer service and interpersonal skills.
• Proficiency in working with payor on-line portals, i.e., NaviNet, Passport, Availity, and other third-party eligibility systems preferred.