Rutgers, The State University of New Jersey is seeking a Clinical Services Representative I performs a variety of billing and collection duties in support of clinic and/or business operations including prior authorizations. Provides guidance, support, and leadership to Clinic Services Representatives II as needed. Functions as a senior staff member handling more complex issues and problems. Performs administrative tasks as assigned to support effective and efficient office operations.
Among the key duties of this position are the following:
Manage requests from physicians, clinical staff, hospitals, community providers and pharmacies using exemplary customer service skills.
Review the patient's EMR for accurate and complete data needed to initiate a request for Prior Authorization of Notification of Services.
Review structured clinical data in the EMR to match against specific medical terms, diagnoses and procedure codes (without need for interpretation) and follow established process for authorization request or referral for additional required information prior to submission for Prior Authorization request.
Required Knowledge, Skills, and Abilities:
Four (4) years of general office billing experience
Three (3) years of which shall have been in a medical billing setting, including management of various types of insurance billing processes and Pre-authorizations.
Experience in accessing and retrieving information from a computer database.
Familiarity with medical terminology.
Superior customer service is required.
Excellent communication and organization skills and a demonstrated ability to work independently
Knowledge of medical services coding .
Physical Demands and Work Environment:
Standing, sitting, walking, talking and hearing. No special vision requirements. Must be able to lift or exert force up to ten (10) pounds.
Moderate noise environment with some exposure (less than 1/3 of the time) to blood borne pathogens requiring the use of personal protective equipment; some potential exposure (less than 1/3 of the time) to hazardous waste.
Rutgers, The State University of New Jersey, is a leading national public research university and the state's preeminent, comprehensive public institution of higher education. Rutgers is dedicated to teaching that meets the highest standards of excellence; to conducting research that breaks new ground; and to turning knowledge into solutions for local, national, and global communities. As it was at our founding in 1766, the heart of our mission is preparing students to become productive members of society and good citizens of the world. Rutgers teaches across the full educational spectrum: preschool to precollege; undergraduate to graduate and postdoctoral; and continuing education for professional and personal advancement. Rutgers is New Jersey's land-grant institution and one of the nation's foremost research universities, and as such, we educate, make discoveries, serve as an engine of economic growth, and generate ideas for improving people's lives.