PATIENT ACCESS SPECIALIST - PART TIME - NIGHT

Overview

Our 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) at Hackensack Meridian Health (HMH). Conducts quality interviews with every patient to ensure compliance with patient safety rules and state and federal regulations. Gathers appropriate identification for patients and confirms all patient demographics to validate patient identity. Conducts intensive screening of all Medicare, Medicaid and managed care patients to identify network status and coordination of benefits. Obtains all applicable patient consents/attestations. Performs job related functions including, but not limited to, facility based scheduling, bed planning, pre-registration, registration, insurance verification, pre-certification, point of service cash collection and financial clearance under the direction of the Supervisor/Manager/Director for these designated areas. Must adhere to the Medical Center\\\’s Quality Standards and maintain a positive patient experience at all times.

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 in order 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 with the 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.
• Initiate real time eligibility query (RTE) on all eligible insurances and review RTE response to ensure correct plan code assignment and coordination of benefits for timely reimbursement.
• Ensure accurate completion of Medicare Secondary Payer Questionnaire and perform insurance verification on all inpatient and outpatient services using the EPIC Financial Estimator tool to determine patient out-of-pocket responsibility.
• Pursues upfront cash collections when appropriate and informs patients of their financial responsibilities, including financial resources, payment plans or payment on date of service.
• Verifies benefits to ensure the procedure is a covered service and that pre-authorization requirements are on file prior to the date of service.
• Submits data timely for all treatments and procedures to ensure authorizations have been obtained and that procedures are authorized prior to date of service.
• Maintains compliance with federal/state requirements and ensures signatures on all required regulatory/consent forms; manual registration during downtime as needed.
• Coordinates daily activities of the Patient Access Department to foster patient comfort and trust and may rotate shifts as needed.
• Responds to high volumes of calls, resolves issues quickly and communicates available resources to patients including financial counseling when appropriate.
• Completes a pre-registration in Epic and clears checklists to set accounts to Confirmed Pre-Registration; schedules Pre-Admission Testing as needed.
• Works with patients to financially clear accounts at least 3 days prior to procedures and facilitates referral to Financial Counselors when appropriate.
• Works in all Access Services areas within the hospital and may rotate shifts; maintains timely updates on process/task changes.
• Meets departmental daily productivity and process standards and complies with departmental policies and workflows.
• Performs additional duties as assigned by supervision and identifies patient needs to tailor care including considerations for age, culture, language, and accessibility.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• High School diploma, GED, or equivalent.
• 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 (Microsoft Office and/or Google Suite).
• Ability to work every other weekend and three of six holidays.

Education, Knowledge, Skills And Abilities Preferred:

• Bachelor\\\’s Degree and/or related experience.
• Minimum of 1+ years of hospital setting experience; patient financial services experience.
• Experience with EPIC (HB, Cadence, Prelude) and knowledge of insurance terms, ICD-10/CPT-4 codes; bilingual skills (Spanish or Korean) are a plus.
• Excellent analytical, written and verbal communication, and interpersonal skills.

Licenses And Certifications Required:

• Successful completion of EPIC Cadence and Prelude training and pass assessment within 30 days after network access is granted.

Compensation

Starting at $25.38 Hourly. HMH is committed to pay equity and transparency for our team members. The posted rate is a good faith estimate of the minimum base pay at the time of posting and does not reflect the full value of our market-competitive total rewards package.