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 who keep getting better, advancing our mission to transform healthcare and serve as a leader of positive change.

The Patient Access Specialist is responsible for all Inpatient and Outpatient Patient Access functions within the Patient Access Services Department in their assigned area/hospital(s). This role conducts quality interviews with every patient to ensure compliance with patient safety rules and state and federal regulations.

Responsibilities

• Greets patients and visitors in person/phone in a prompt, courteous, respectful and helpful manner.
• Implements the Medical Center's scheduling, pre-registration, pre-certification, referral procurement and insurance verification policies and procedures for the assigned outpatient point of service.
• Adheres to patient identification policy and ensures an accurate patient search is performed to maintain patient safety and prevent duplicate medical record numbers.
• Checks-in and accounts for the location and arrival/processing time of patients to ensure prompt service within established departmental time frames and guidelines.
• Ensures Regulatory Forms are filled out and signed by the patient.
• Performs all functions of bed planning; reservations/pre-registration/bed assignment and prioritizes bed assignment in accordance with policy.
• Ensures patients are assigned to the proper unit according to admit order and reviews orders to ensure patient is in appropriate status and level of care.
• Initiates real time eligibility query (RTE) on all eligible insurances and reviews RTE response to ensure correct plan code assignment and coordination of benefits.
• Ensures accurate completion of Medicare Secondary Payer Questionnaire.
• Performs insurance verification on all Inpatient and Outpatient services and determines the patient's out-of-pocket responsibility via the EPIC Financial Estimator tool.
• Pursues upfront cash collections to assist patients in understanding their financial responsibilities and minimize overall bad debt.
• Informs patients of their out-of-pocket responsibility, taking payment via credit card or in person, and explaining financial resources including financial assistance, payment plans, or payment on date of service.
• Verifies benefits to ensure the procedure is a covered service under the patient's plan prior to receiving services.
• Verifies pre-authorization requirements and follows up with both the referring physician and payer to ensure authorizations are on file for the scheduled procedure prior to date of service.
• Submits all data timely, effectively, and expeditiously for all treatments and procedures to ensure authorizations have been obtained.
• Ensures diagnosis data 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 during downtime and follows proper registration input procedures when the system becomes available.
• Mediates daily scheduling, pre-registration, pre-certification, or registration issues and escalates unresolved issues.
• Completes assigned work queue (WQ) accounts in a timely and efficient manner.
• Assumes other responsibilities as directed by the Supervisor, Manager, or Director of Patient Access.
• Identifies the needs of the patient population served and modifies care delivery accordingly (e.g., age, culture, language, hearing, or visually impaired).
• Ensures delivery of excellent customer service resulting in a positive patient experience.
• Complies with all procedural workflows and departmental policies and procedures.
• Scans documents and correspondence from patients and payers.
• Coordinates daily activities of the Patient Access Department to foster an environment promoting patient comfort and trust.
• Schedules patients as needed and answers a high volume of phone calls in a professional manner.
• Resolves issues quickly and accurately.
• Ensures timely notification of admission to payers and refers accounts to Case Management for timely submission of clinical information.
• Verifies eligibility and benefits to confirm active coverage and that the procedure is covered under the patient's plan prior to the date of service.
• Follows up with referring physician offices and payers to ensure authorizations are on file for scheduled procedures.
• Accesses and navigates 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 and resolves coverage issues.
• Makes referrals to Financial Counselors if appropriate.
• Processes all methods of acceptable payments such as cash, check, money order, and credit card transactions accurately and timely.
• Reconciles daily cash drawer or shift payment transactions, deposits daily cash/check, and provides patients with cash receipts and/or service estimates.
• Completes pre-registration on all appropriate patients in Epic and clears checklists to set account status to "Confirmed pre-reg."
• Contacts patients and/or physicians' offices regarding Pre-Admission Testing scheduling in a timely and efficient manner.
• Obtains patient records and processes scheduling information, including copying, filing, faxing, and answering phone calls accurately and professionally.
• Works in all Access Services areas within the hospital and may rotate shifts as needed.
• Checks email daily to maintain timely updates on process/task changes.
• Meets departmental daily productivity and process standards.
• Adheres to HMH Organizational competencies and standards of behavior.
• Lifts a minimum of 20 lbs., pushes and pulls a minimum of 300 lbs., and stands a minimum of 4 hours a day.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• 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.

Education, Knowledge, Skills and Abilities 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 (e.g., Spanish or Korean).
• Experience with EPIC HB, Cadence, and Prelude.

Licenses and Certifications Required:

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

Pay

Minimum rate of $25.77 hourly. The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted rates may vary based on labor market data, experience, education, certifications, skills, geographic location, internal equity, budget, and grant funding.

Certain positions may be eligible for shift differentials for work performed on evening, night, or weekend shifts. In addition to base compensation, HMH offers a comprehensive benefits package for full-time and part-time (20+ hours/week) job positions, including health, dental, vision, paid leave, tuition reimbursement, and retirement benefits.