Healthcare Access Specialist

The Healthcare Access Specialist ensures accurate patient registration and validates insurance to support proper benefit verification and timely reimbursements. They collect and review all patient insurance information using electronic verification tools and payer portals such as NaviNet, Availity, PEAR, and Notivasphere. They investigate missing data, troubleshoot coverage questions, and coordinate benefits to ensure Medicare and Medicaid requirements are met. They handle regulatory forms and notices of admission (CMS IMM, CMS MOON, CMS NSA) and submit admissions notices to payors via electronic portals or fax as appropriate. They communicate with physicians, medical examiners, the Sharing Network, and funeral directors to ensure timely handling of admissions and, when applicable, initiate NJ EDRS death records. They perform point-of-service collections and maintain high accuracy, with strong organizational skills and the ability to work independently or as part of a team.