LEAD 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 offer competitive rates and compensation programs, a comprehensive benefits program for full and part-time employees, attractive working conditions, and opportunities for career growth through professional development.

About the Role

The Lead HCA Patient Access Specialist plays an essential role in ensuring a smooth and efficient experience for patients navigating the healthcare system. Under supervisory direction, the Lead will help oversee the operations of the team responsible for Admissions and Insurance Verification, ensuring patients receive timely and respectful service from registration to insurance verification. Their leadership ensures the team operates cohesively, maintaining high standards of accuracy and confidentiality in handling patient information.

The Lead will assist with training and development of the HCA Patient Access Specialist team, ensuring staff are up-to-date with the latest policies and procedures. They will assist with problem-solving, monitor performance metrics, complete audits, and perform quality monitoring of completed accounts.

This role requires knowledge of state and federal government funding programs such as Medicare and Medicaid, including requirements for timely notification of rights and proper correspondence (e.g., CMS IMM, CMS MOON, NJ Observation, CMS NSA forms). The Lead will use electronic insurance verification tools, portals (e.g., NaviNet, Availity, PEAR, Notivasphere), and telephonic verification as needed. They ensure payers receive a Notice of Admission for all admissions within 24 hours or the next business day, submitting notices via electronic portal or fax.

The Lead also communicates with physicians, NJ Medical Examiners, the Sharing Network, and funeral directors to ensure timely handling of deceased patients and initiates electronic death records via NJ EDRS.

Responsibilities

• Oversee operations of the Admissions and Insurance Verification team to ensure smooth patient access processes.
• Train and develop team members on policies, procedures, and best practices.
• Assist with problem-solving and monitor team performance metrics.
• Complete audits and quality monitoring of completed accounts.
• Ensure compliance with state and federal funding programs (e.g., Medicare, Medicaid) and timely notification requirements.
• Secure and deliver required correspondence (e.g., CMS IMM, CMS MOON, NJ Observation, CMS NSA forms).
• Use electronic insurance verification tools, portals (e.g., NaviNet, Availity, PEAR), and telephonic verification.
• Submit Notice of Admission to payors within 24 hours or the next business day via electronic portal or fax.
• Communicate with physicians, NJ Medical Examiners, the Sharing Network, and funeral directors for deceased patient handling.
• Initiate electronic death records via NJ EDRS.

Requirements

• 3-5 years of experience in registration, billing, or a related role in a medical facility.
• Proficiency in patient registration, scheduling, medical insurance pre-certifications, authorizations, and referrals.
• High School Diploma or GED required; Associate's degree preferred.
• Excellent verbal and written communication skills.
• Experience with computers and software applications (e.g., Microsoft Word, Excel, Outlook, Access, registration, and billing systems).
• Exceptional customer service and interpersonal skills.

Preferred Qualifications

• Epic experience.
• NAHAM Certified Healthcare Access Associate (CHAA) certification.
• HFMA Certified Revenue Cycle certifications.
• Proficiency in payor online portals (e.g., NaviNet, Passport, Availity, and other third-party eligibility systems).

Benefits

• Comprehensive benefits program for full and part-time employees, including health, dental, vision, life, and disability insurance.
• Retirement benefits.
• Opportunities for career growth through professional development.