Healthcare Access Specialist

HCA Patient Access Specialist

The HCA Patient Access Specialist communicates with insurance companies, patients, and healthcare providers to resolve discrepancies, update records, and ensure proper billing. Accuracy is crucial to prevent claim denials and facilitate smooth reimbursement processes. This role requires attention to detail, strong organizational skills, knowledge of insurance policies, sense of urgency to meet time-sensitive insurance requirements, and effective communication skills to navigate the complexities of healthcare billing.

The HCA Patient Access Specialist is responsible for ensuring quality patient registration, validation, and verification of insurance information. Collects and reviews all patient insurance information needed to complete the benefit verification process. Investigates missing data needed to complete the verification process. Troubleshoots and seeks solutions to problems related to questions and concerns over health insurance coverage. Knowledgeable with coordination of benefits and completing MSPQ episodically to ensure proper coordination for Medicare recipients. Additional responsibilities include point of service collections, positive telephone etiquette, and patient satisfaction in support of Cooper University Hospital Mission and Core Values. Must be able to work independently and as a team with an enthusiastic personality.

Knowledgeable of state and federal government funding programs such as Medicare, Medicaid, and requirements to satisfy timely notification of rights as it pertains to these programs. Additionally, securing and delivering proper correspondence needed to satisfy those requirements such as CMS IMM, CMS MOON, NJ Observation, and CMS NSA forms.

Uses all modes of electronic insurance verification, RTE, portals such as NaviNet, Availity, PEAR, Notivasphere, insurance verification websites as well as telephonic verification as needed. When appropriate, ensures the payer receives a Notice of Admission on all admissions, scheduled and non-scheduled, within 24 hours or the next business day. Submits notice of admissions to all payors via electronic portal or fax transmittal as appropriate and timely.

The HCA Patient Access Specialist communicates as appropriate with the physicians, NJ Medical Examiners, the Sharing Network, and Funeral Directors to ensure timely handling of deceased patients. Initiates electronic death record via NJ EDRS.

Experience Required

• 2 years Required
• 3-5 years preferred.
• Preferred Experience includes:
  • Minimum one year of registration or billing experience working in a medical facility.
  • Proficiency in patient registration, scheduling, medical insurance pre-certifications, authorizations, and referrals
  • Epic experience preferred

Education Requirements

High School Diploma or Equivalent required.

License/Certification Requirements

NAHAM Certified Healthcare Access Associate (CHAA) certification or HFMA Certified Revenue Cycle certification (Preferred)

Special Requirements

• Excellent verbal and written communications skills
• Experienced in use of computers and software applications, i.e., Microsoft Word, Excel, Outlook, Access,
• registration, and billing systems.
• Exceptional customer service and interpersonal skills
• Proficiency in working with payor on-line portals, i.e., NaviNet, Passport, Availity, and other third-party eligibility systems preferred.

Salary Min ($)

USD $21.00

Salary Max ($)

USD $33.00