Patient Access Specialist- FT- Evening

• 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.
• Prioritizes bed assignment in accordance with policy.
• Ensures patients are assigned to the proper unit according to admit order.
• Reviews orders to ensure patient is in appropriate status and level of care.
• 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.
• Ensure 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 using the applicable data.
• Where appropriate, 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 patients 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 and determine that the procedure or treatment is authorized prior to date of service.
• Ensures diagnosis data that is 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 when in `downtime' mode and properly follows registration input procedures when the system becomes available.
• Attempts to mediate daily scheduling, pre-registration, pre-certification or registration issues and elevates any issues that cannot be resolved independently.

• High School diploma, general equivalency diploma (GED), and/or GED equivalent programs
• 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.

• 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.

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

Hackensack Meridian Health