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||Hackensack Meridian Health
||Edison, NJ United States
|| Finance/Economics, Executive Management, Environmental
Patient Access Specialist (FT-Hackensack)|
How have you impacted someone's life today? At Hackensack Meridian Health our teams are focused on changing the lives of our patients by providing the highest level of care each and every day. From our hospitals, rehab centers and occupational health teams to our long-term care centers and at-home care capabilities, our complete spectrum of services will allow you to apply your skills in multiple settings while building your career, all within New Jersey's premier healthcare system.
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) 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.
A day in the life of a Patient Access Specialist at Hackensack Meridian Health includes:
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.
Initiate real time eligibility query (RTE) on all eligible insurances. Must review RTE response to ensure correct plan code assignment and correct coordination of benefits to facilitate timely reimbursement.
Performs insurance verification on all Inpatient and Outpatient services, and determines the patient's out of pocket responsibility via the EPIC Financial Estimator tool using the applicable data.
Answers a high volume number of phone calls and responds in an appropriate/professional manner. Address and resolve any issues quickly/accurately.
Ensures timely notification of admission to payers and refers accounts to Case Management for timely submission of Clinical Information to payer.
Verifies pre-authorization requirements and follows 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.
Works with patients to financially clear their account per policy at least 3 days prior to procedure. Resolves any issues with coverage and escalates any complications to supervisor/manager. Makes referrals to Financial Counselors if appropriate.
Accurate and timely processing of all methods of acceptable payments such as cash/check/money order/credit card transactions. Reconciling daily cash drawer or shift payment transactions, depositing daily cash/check and providing patients with cash receipts, and/or service estimate.
Obtains patient records, types and processes scheduling information included but not limited to copying, filing, faxing and answering phone calls in an accurate, efficient and professional manner.
Qualifications & Requirements
Education, Knowledge, Skills and Abilities Required:
High School Diploma or Equivalency.
Minimum of 1+ years of experience in a hospital setting.
Good written and verbal communication skills.
Customer Service Oriented.
Basic medical terminology knowledge.
Prior registration/insurance verification experience.
Proficient computer skills that may include but are not limited to Microsoft Office and/or Google Suite platforms.
Patient Financial services experience in a professional or hospital setting.
Ability to work every other weekend.
Ability to work three (3) out of six (6) holidays.
Ability to work rotating schedules/shifts based on needs.
Education, Knowledge, Skills and Abilities Preferred:
Bachelor's Degree and/or related experience.
Minimum of 2+ years experience in a hospital setting.
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 Required:
Successfully complete EPIC Cadence and Prelude training and pass assessment that follows within 30 days after Network access is granted
Hackensack Meridian Health|
Hackensack Meridian Health is a leading not-for-profit health care organization that is the most comprehensive and truly integrated health care network in New Jersey, offering a complete range of medical services, innovative research and life-enhancing care. Hackensack Meridian Health comprises 17 hospitals, including three academic medical centers, two children’s hospitals, nine community hospitals, two rehabilitation hospitals, and more than 450 patient care sites and physician offices. Hackensack Meridian Health has over 36,000 team members, more than 6,500 physicians and is a distinguished leader in health care philanthropy, committed to the health and well-being of the communities it serves.