LEAD HEALTHCARE ACCESS SPECIALIST

At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development.

Discover why Cooper University Health Care is the employer of choice in South Jersey.

The Lead HCA Patient Access Specialist will be responsible for the duties and skills of an HCA Patient Access Specialist.

The Lead HCA Patient Access Specialist plays an essential role in ensuring a smooth and efficient experience for patients navigating the healthcare system. Under supervisory direction, the Lead will help to oversee the operations of the team responsible for Admissions and Insurance Verification. This individual ensures that patients receive timely and respectful service, from registration to insurance verification. Their leadership ensures that the team operates cohesively, maintaining a high standard of accuracy and confidentiality in handling patient information. Through their guidance, the HCA Patient Access Specialist Lead supports not only the operational efficiency of healthcare facilities but also enhances patient satisfaction, making the initial steps of healthcare access as seamless as possible.

The Lead will help with the training and development of the HCA Patient Access Specialist team ensuring new and existing staff are up to date with the latest policies and procedures. They will assist with problem solving and monitoring performance metrics. The Lead will assist in completing audits and quality monitoring of completed accounts.

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 Lead 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.

• Must have 3-5 years of experience in Healthcare Access Management skills.

• High school diploma/GED required, Associate college preferred.

• Strong Customer Service utilizing AIDET to ensure the objective of meeting the patient's needs.
• Independently controls and monitors workflow during process to ensure quality and accuracy in all encounters.
• Schedule PCP follow up within 7 days of discharge from inpatient. If patient has no PCP will assist with obtaining new PCP.
• Verification and data entry of all required registration and scheduling components during each encounter. This includes but is not limited to patient demographics, insurance verification, plan codes, authorizations/referrals, orders, guarantor type, HAR/patient class, room patients when applicable.
• Inform patients of billing policies and managed care referral and/or pre-authorization requirements including Out of Network services.
• Insurance and benefit verification - utilize RTE and various payer portals to verify eligibility and benefits for services being provided. This may include plan codes, eligibility, coordination of benefits and subscriber information.
• Orders - Review EPIC and outside orders to ensure order follows all compliance requirements. This includes but is not limited to ANC Orders, Lab orders, Procedural orders, and PT/OT work orders, Media Manager, etc.
• Point of Service Collections - need to capture and ensure collection of self-pay costs, estimates, copays, and past due payments. This includes processing refunds, printing receipts, and printing past due statements. Daily reconciliation of user cash drawer.
• Complete Payment Plans to secure future payments and educate the patients on their financial responsibility.
• Compliance Forms - Capture all required consent forms at time of service including Out of Network forms.
• Track and report weekly on all scheduled services.
• Float to other ED, Inpatient, Urgent Care Centers Navigation work areas, as needed, to assist with patient access to Cooper services.
• Responsible for EMR documentation/tasks in telephone encounters, in-baskets, e-fax, work queues as assigned.
• Assist and function as liaison for the supervisor/manager in patient scheduling issues, training, education, communication, and problem solving.
• Audit scheduled and registered encounters and review with team members.
• Collaborate with EPIC Analysts to create dashboards, reporting tools, and accountable for monitoring open help desk tickets within scope of responsibilities.
• Track inventory, order office supplies/forms, assist in scheduling meetings, taking minutes etc.