Specialist Req #: 0000171167
Category: Billing/Collections/Registration
Status: Full-Time
Shift: Day
Facility: RWJ Somerset
Department: Patient Access Services
Location: RWJUH Somerset, 110 Rehill Ave, Somerville, NJ 08876

Job Summary:

The Patient Access Specialist supports the Patient Access Department by providing key operational functions to identify opportunities and minimize risk. The Patient Access Specialist position plays a key role within the health system by ensuring all steps are taken to financially secure accounts prior to or during service.

Qualifications:

Required:

High School Diploma requiredMinimum of 5 years in Patient Access roleExtensive knowledge of payer authorization requirementsKnowledge in all aspects of Patient Access work flowsAdvanced Excel experience Knowledge of Medical terminology and computer skills

Preferred:

College degree preferred

Scheduling Requirements:

Day ShiftRotating weekends and holidays may be requiredFull-Time

Essential Functions:

A core function of this position is to ensure that authorization requirements are met prior to serviceThe Patient Access Specialist provides direct and indirect support to department by analyzing data to identify issues and opportunities, reduce denials and improve processesThe Patient Access Specialist has in-depth knowledge of payer authorization requirements, protocols for obtaining and confirming appropriate authorization for the clinical services rendered and minimizing financial riskThe Patient Access Specialist has extensive knowledge of payer requirements and is able to clearly understand and articulate with clinical and non-clinical staffProvides excellent customer service to all patients, colleagues and other external and internal customersEnsures appropriate authorization has been issued by the payer prior to serviceCommunicate clearly with clinical staff and payer representatives to authorize servicesReview script and/or medical service documentation to ensure authorizations match services providedInterviews patients, family members and other responsible parties to gather pertinent informationMeets and exceeds department goals including accuracy and productivityDemonstrates proficiency in the entire pre-admission, registration, and financial clearance processesDemonstrates initiative and motivation in role; proactively identifies and resolves problems in an appropriate manner and escalates issues to leadership when necessaryUtilize system generated reports to analyze dataAnalyze denial data to determine root cause, identify issues and areas of opportunityCreate tracking and trending reportsProvide summary findings and recommendations to leadership teamsAssist with creating action plans to address and resolve issues pertaining to incorrect insurance and authorization denialsDevelop reports to quantify the value and financial risk for each areaAudit and review work flow, patient processing and quality standardsReflects commitment to building a supportive work environment and maintains a positive attitudeWorks closely and professionally with clinical staff and ancillary departments to foster a team environmentParticipate in training through the development of training tools, presentations at department in-services or staff meetings, or through the training of registration staff outside of the patient access department

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Benefits and Perks:

At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health.

Paid Time Off (PTO) Medical and Prescription Drug InsuranceDental and Vision InsuranceRetirement PlansShort & Long Term DisabilityLife & Accidental Death InsuranceTuition ReimbursementHealth Care/Dependent Care Flexible Spending AccountsWellness ProgramsVoluntary Benefits (e.g., Pet Insurance)Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!

Choosing RWJBarnabas Health!

RWJBarnabas Health is the premier health care destination providing patient-centered, high-quality academic medicine in a compassionate and equitable manner, while delivering a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.

RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.

RWJBarnabas Health is an Equal Opportunity Employer