Patient Access Analyst, Oncology

Hackensack Meridian Health Inc.; West Grove (NJ); On-site; USD 42,000 - 65,000; Full time

Job summary

Hackensack Meridian Health is seeking a Patient Access Analyst in Oncology to support prior authorization for chemotherapy, radiation and diagnostic imaging within our care teams. You will coordinate patient registration, scheduling and billing in the approved systems while verifying insurance coverage and obtaining necessary approvals.

Ideal candidates have a strong oncology terminology background, experience with EPIC or similar EHRs, and proven ability to work under pressure while delivering

Qualifications

• Associate's degree or related work experience.
• Minimum of 3 years of experience in a hospital setting or medical/clinical office.
• Prior experience with an electronic health record system (EPIC preferred).
• Knowledge of medical terminology, oncology terminology preferred.
• Experience analyzing NCCN, FDA and CMS guidelines for cancer diagnosis.
• Strong communication and customer service skills for coordinating with physicians, patients and payers.

Responsibilities

• Coordinate patient precertification/authorization for oncology services.
• Assist with patient registration, scheduling and billing in electronic systems.
• Perform on-site insurance verification and navigate payer portals for prior approvals.
• Communicate predetermination of medical necessity to clinicians and care teams.

Skills

Medical Terminology

Communication skills

Customer service

Microsoft Office or Google Suite

Teamwork

Bilingual (Spanish or Korean)

Education

Associate's degree

Bachelor's degree

Tools

EPIC Cadence

Prelude

ARIA

EPIC HB

Job description

Our team members are the heart of what makes us better.

At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community.

Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

The Patient Access Analyst, Oncology provides assistance to patients, Physicians, caregivers in all areas of Oncology /Radiation Oncology services in the HMH Health care system. This pertains to Prior Authorization for Oncology services, as well as various specialized services ordered by clinical caregivers which may require prior approvals to avoid loss of revenue for both professional and facility services and surprise out of pocket costs. This position is responsible for coordinating all the functions and activities related to patient precertification/authorization for Chemotherapy, Radiation, and Diagnostic Imaging associated with a patient's plan of treatment. This includes but is not limited to: accurate and complete patient registration in the approved organization electronic scheduling and billing systems and on-site insurance verification while being able to navigate the various Insurance portals where clinical data is submitted to substantiate the request for prior approvals for oncology services.

Education, Knowledge, Skills and Abilities Required:

• Associate's degree and/or related work experience.
• Minimum of 3 years of experience in a hospital setting or medical/clinical office.
• Prior experience with an electronic health record system (especially EPIC clinical or ARIA) preferred.
• Prior relevant experience, such as doing prior auths in MD office, or related hospital or Physician based services.
• Demonstrated knowledge of medical terminology, preferably in Oncology, with strong understanding of cancer medical terminology.
• Prior experience in analyzing the NCCN, FDA and CMS guidelines for cancer diagnosis.
• Effective oral and written communication skills to analyze and understand predetermination of medical necessity provided by insurance payers to convey and communicate to clinical care givers (Physicians, Nurse Practitioners and RN case managers.
• Ability to deal effectively and professionally with a variety of different individuals both clinical, clerical and professionals in oncology settings.
• Ability to perform in a high-pressure environment.
• Customer Service Oriented.
• Proficient computer skills that may include but are not limited to Microsoft Office and/or Google Suite platforms.
• 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.

Education, Knowledge, Skills and Abilities Preferred:

• Bachelor's Degree and/or related experience.
• 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.

Licenses and Certifications Required:

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