Patient Access Specialist - Per Diem - Day

About the role

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.

Responsibilities

• Greet patients and visitors in person/phone in a prompt, courteous, respectful and helpful manner.
• Implement the Medical Center's scheduling, pre-registration, pre-certification, referral procurement and insurance verification policies and procedures for the assigned outpatient point of service.
• Adhere to patient identification policy and ensure an accurate patient search is performed to maintain patient safety and prevent duplicate medical record numbers.
• Check-in and account for the location and arrival/processing time of patients to ensure prompt service within established departmental time frames and guidelines.
• Ensure Regulatory Forms are filled out and signed by the patient.
• Perform all functions of bed planning; reservations/pre-registration/bed assignment.
• Prioritize bed assignment in accordance with policy; ensure patients are assigned to the proper unit according to admit order.
• Review orders to ensure patient is in appropriate status and level of care.
• Initiate real time eligibility query (RTE) on all eligible insurances; review RTE response to ensure correct plan code assignment and correct coordination of benefits to facilitate timely reimbursement.
• Ensure accurate completion of Medicare Secondary Payer Questionnaire.
• Perform insurance verification on all Inpatient and Outpatient services, and determine the patient's out of pocket responsibility via the EPIC Financial Estimator tool using applicable data.
• Pursue upfront cash collections to assist patients in understanding their financial responsibilities and minimize overall bad debt.
• Inform patients of their out of pocket responsibility, take payment via credit card or in person, and explain financial resources including financial assistance, payment plans or payment on date of service.
• 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 and payer to ensure authorizations are on file for the scheduled procedure prior to date of service.
• Submit 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 date of service.
• Ensure diagnosis data entered on registration is accurate and meets medical necessity criteria.
• Comply with HMH's patient financial responsibility and collection policies.
• Provide patients with appropriate administrative information, as directed.
• Maintain compliance with federal/state requirements and ensure signatures are obtained on all required regulatory/consent forms.
• Manually register patients accurately when in downtime mode and properly follow registration input procedures when the system becomes available.
• Attempt to mediate daily scheduling, pre-registration, pre-certification or registration issues and elevate any issues that cannot be resolved independently.
• Complete assigned work queue (WQ) accounts in a timely and efficient manner.
• Assume other responsibilities as directed by the Supervisor, Manager or Director of Patient Access.
• Identify the needs of the patient population served and modify and deliver care that is specific to those needs (i.e., age, culture, language, hearing and/or visually impaired, etc.). Communicate with the patient, parent, and/or primary caregiver(s) at their level (developmental/age, educational, literacy, etc.).
• Ensure delivery of excellent customer service resulting in a positive patient experience.
• Comply with all procedural workflows and departmental policies and procedures as identified.
• Responsible for scanning any documents and correspondence from patients and payers.
• Coordinate daily activities of the Patient Access Department which fosters an environment promoting patient comfort and trust.
• Schedule patients as needed.
• Answer a high volume number of phone calls and respond in an appropriate/professional manner; address and resolve any issues quickly and accurately.
• Ensure timely notification of admission to payers and refer accounts to Case Management for timely submission of Clinical Information to payer.
• Verify 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.
• 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.
• Access and navigate various payer websites (e.g., Navinet) to confirm patients' insurance coverage and policy benefits.
• Work with patients to financially clear their account per policy at least 3 days prior to procedure; resolve any issues with coverage and escalate any complications to supervisor/manager; make referrals to Financial Counselors if appropriate.
• Accurately and timely process all methods of acceptable payments such as cash/check/money order/credit card transactions; reconcile daily cash drawer or shift payment transactions, deposit daily cash/check and provide patients with cash receipts and/or service estimate.
• Complete a pre-registration on all appropriate patients in Epic; clear a checklist in Epic and set an account status to “Confirmed pre-reg.”
• Contact patients and/or physicians' offices in regards to Pre-Admission Testing scheduling in a timely and efficient manner.
• Obtain patient records, type and process scheduling information including but not limited to copying, filing, faxing and answering phone calls in an accurate, efficient and professional manner.
• Work in all Access Services areas within the hospital and may rotate shifts as needed.
• Check email daily to maintain timely updates on any process/task changes/updates.
• Meet departmental daily productivity and process standards.
• Perform other duties and/or projects as assigned.
• Adhere to HMH Organizational competencies and standards of behavior.

Qualifications

• 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

• 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

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

Pay

Minimum rate of $25.77 hourly.