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Cooper University Health Care

HEALTHCARE ACCESS SPECIALIST

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What they do

An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.

$51,009 / year median in New Jersey

+24% projected growth

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Job Description

About us 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. Short Description 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 in -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 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.