Verification/Authorization Specialist
Patient access representative job in Bridgewater, NJ
Job Title: Verification/Authorization Specialist
Employment Type: Full-time, Hybrid 2 days remote
Schedule: Monday - Friday
About Us
Performance Ortho is a leading provider of comprehensive orthopedic and outpatient care in New Jersey. With four clinic locations, an Ambulatory Surgery Center, and our corporate headquarters in Bridgewater, we're celebrating 24 years of growth and excellence. Our holistic approach includes a wide array of services-Chiropractic, Physical Therapy, Acupuncture, Occupational Therapy, and Orthopedic Surgery-all aimed at delivering the highest quality of patient care. We pride ourselves on fostering a collaborative, supportive work environment where our team members are empowered to thrive and grow.
Job Overview
The Verification/Authorization Specialist is responsible for conducting detailed verification of patient eligibility and benefits, as well as securing required authorizations for services across government, commercial, and third-party payers. This role ensures accurate and timely eligibility and authorization determinations while adhering to compliance regulations. The specialist will collaborate with internal teams, external vendors, and insurance providers to resolve discrepancies, streamline processes, and maintain data integrity.
A strong understanding of Medicare, Medicare Advantage, private insurance plans, and other third-party payers is essential for success in this role.
Key Responsibilities
Eligibility & Verification
Conduct detailed reviews of patient insurance coverage, supporting documents, and eligibility criteria.
Verify patient insurance and benefit information for scheduled services, including diagnostics, therapies, and surgeries.
Process eligibility determinations in accordance with company policies and payer guidelines.
Authorizations
Obtain pre-authorizations and referrals as required by insurance carriers.
Communicate with insurance representatives to ensure timely approval of procedures and services.
Track and follow up on pending authorizations to prevent delays in care.
Compliance & Quality Assurance
Ensure all verification and authorization activities align with company standards and regulatory requirements.
Conduct audits and quality checks to maintain accuracy and minimize errors.
Stay updated on payer policy changes and industry best practices.
Case Management & Collaboration
Manage complex cases, including appeals, escalations, and exceptions.
Collaborate with internal departments-billing, scheduling, and clinical teams-to resolve insurance-related issues.
Provide guidance and support to junior staff as needed.
Documentation & Reporting
Maintain accurate and up-to-date records in EHR and billing systems.
Prepare reports and summaries on verification and authorization trends.
Ensure compliance with HIPAA and internal confidentiality standards.
Communication & Patient Support
Respond to inquiries from patients, providers, and other stakeholders.
Clearly and professionally explain insurance coverage, eligibility status, and authorization outcomes.
Support the development of internal communication materials and policy updates.
Preferred Candidate Attributes
Exceptional attention to detail and accuracy
Strong analytical and problem-solving skills
Excellent communication and customer service abilities
Ability to handle confidential information with discretion
Team-oriented mindset with a proactive, solutions-driven approach
Capable of managing multiple tasks and meeting deadlines in a fast-paced environment
Qualifications
High school diploma or equivalent; Associate degree in healthcare administration or related field preferred
Minimum of 2 years of experience in verification, authorization, eligibility determination, or a related healthcare role
Familiarity with orthopedic billing codes, payer requirements, and insurance policies
Knowledge of EHR systems and billing software (eClinicalWorks experience preferred)
Proficiency in Microsoft Office Suite, especially Excel
Strong communication skills, both written and verbal
Ability to work independently and collaboratively within a team
Must be able to work onsite in Somerset County, NJ
Customer Service Representative
Patient access representative job in Woodbridge, NJ
Are you ready to embark on a rewarding career journey? At Plymouth Rock, we pride ourselves on fostering a dynamic and supportive service center environment where professionalism and teamwork are highly valued. If you're the kind of person who enjoys solving problems and helping others when they need it, this could be a great opportunity to start your career at Plymouth Rock!
We're currently seeking passionate individuals to join our team as Customer Service Representatives, where you'll play a pivotal role in providing exceptional service to our valued customers, agents, and partners. As a Customer Service Representative, you'll be at the forefront of our customer interactions, handling inbound calls with efficiency and professionalism.
RESPONSIBILITIES
• Answer inquiries via phone, email and texting regarding policies, coverages, and premiums with confidence and accuracy.
• Ensure first call resolution, making the customer experience as seamless as possible.
• Develop and maintain comprehensive product knowledge across all three lines of insurance (Auto, Homeowner, and Umbrella).
• Cultivate strong relationships with our agents and partners, contributing to our collaborative work environment.
• Utilize your analytical and decision-making skills to address policy changes and corrections effectively.
• Exceed customer and agent expectations by delivering top-notch service through positive interactions and extensive product expertise.
• The ability to work a flexible schedule is a critical aspect of this position. Hours for this position are shifts between: 8:00am-7:00pm Monday - Friday and 10:00am-3:00pm every third Saturday.
QUALIFICATIONS
• Strong interpersonal, communication, and organizational skills.
• Analytical mindset with good decision-making abilities.
• Proficiency in computer skills and data entry.
• High motivation to take ownership and follow up on tasks.
• Flexibility to adapt to a fast-paced, changing environment.
• Ability to work weekdays and rotational Saturdays.
• High school diploma required, college degree is a plus!
• Spanish language proficiency is a plus!
SALARY RANGE
The pay range for this position is $45,000 to $49,500 annually. Actual compensation will vary based on multiple factors, including employee knowledge and experience, role scope, business needs, geographical location, and internal equity.
PERKS & BENEFITS
• 4 weeks accrued paid time off + 9 paid national holidays per year
• Low cost and excellent coverage health insurance options that start on Day 1 (medical, dental, vision)
• Annual 401(k) Employer Contribution
• Free onsite gym at our Woodbridge Location
• Resources to promote Professional Development (LinkedIn Learning and licensure assistance)
• Robust health and wellness program and fitness reimbursements
• Various Paid Family leave options including Paid Parental Leave
• Tuition Reimbursement
ABOUT THE COMPANY
The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner's insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
#LI-DNI
Scheduling Coordinator (640083)
Patient access representative job in Newtown, PA
Seeking $26/hr. for Entry Level with applicants with recent degrees in Supply from 2023, 2024 or 2025. OR, scheduling experience (up to $30/hr.). These roles are Contract to Hire after 6 months.
Must Haves:
Bachelors Degree. 6+ month of some sort of Logistics/Supply Chain Coordination experience
Work Schedule:
Work schedule is based on 365 days a year (and team works 24 hours a day): 2 days on, 2 days off, 3 days on, 3 days off - they do not have a traditional Monday-Friday schedule. Work weekends and on all holidays like July 4th, Thanksgiving, Christmas, etc based on how the schedule falls.
A detailed job description will be provided to interested and qualified applicants.
DM OR call ************ OR Email ****************************
Scheduling Coordinator
Patient access representative job in Tinton Falls, NJ
BAYADA Home Health Care has an immediate opening for a Full-time Scheduling Coordinator in our Tinton Falls, NJ Assistive Care office!
BAYADA believes that our clients and their families deserve home health care delivered with compassion, excellence, and reliability. We want you to apply your energy and skills in this dynamic, entrepreneurial environment and become an integral part of a caring, professional team that is instrumental in providing the highest quality care to our clients.
The Scheduling Coordinator will:
Provide superior customer service and quality home care
Focus on managing coordination of client services and emergent scheduling issues
Build lasting relationships with clients, referral sources, payors and community organizations
Develop strong, communicative relationships with the team
Associates will partner with Clinical Managers to provide support to field employees
Qualifications for a Scheduling Coordinator:
Prior supervisory experience a plus
Demonstrated record of successfully taking on increased responsibility (goal achievement)
Ambition to grow and advance beyond current position
Strong computer skills required (electronic medical record)
Excellent communication and interpersonal skills
Why You'll Love This Opportunity:
Award-Winning Workplace: Proud to be recognized by Newsweek as a Best Place to Work for Diversity, reflecting our commitment to creating an inclusive, supportive environment.
Weekly Pay - Consistent weekly paychecks to keep your finances on track.
Comprehensive Benefits - Medical, dental, vision, and more - we've got you covered
Work-Life Balance - We are flexible with your schedule.
Career Growth - Advancement opportunities to help you grow in your nursing career.
Nonprofit Organization - As a mission-driven nonprofit, BAYADA offers eligibility for the Public Service Loan Forgiveness (PSLF) Program to help reduce student loan debt.
Salary: $20- $23/HR depending on qualifications
As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all state/local mandates.
BAYADA is celebrating 50 years of compassion, excellence, and reliability. Learn more about our 50th anniversary celebration and how you can join in here .
BAYADA Home Health Care, Inc., and its associated entities and joint venture partners, are Equal Opportunity Employers. All employment decisions are made on a non-discriminatory basis without regard to sex, race, color, age, disability, pregnancy or maternity, sexual orientation, gender identity, citizenship status, military status, or any other similarly protected status in accordance with federal, state and local laws. Hence, we strongly encourage applications from people with these identities or who are members of other marginalized communities.
SEEKING EXPERIENCED PATIENT CARE COORDINATOR / FRONT DESK
Patient access representative job in Princeton Junction, NJ
Job DescriptionOverview Join our fast growing team of dedicated, happy, positive people making a difference in patient's lives! SEEKING EXPERIENCED PATIENT CARE COORDINATOR / FRONT DESK MUST speak fluent English and Spanish.
Prepare provider's clinic schedule to ensure all necessary documents are on file and we are well prepared for the day.
Provide education and support to patients and their families regarding the provider's treatment recommendations.
Ensure compliance with healthcare regulations and standards while maintaining patient confidentiality.
Facilitate referrals to appropriate services such as physical therapy, pain management, or diagnostic imaging.
Document all interactions and updates in the patient's medical records accurately.
Skills
Strong knowledge of clinic operations and medical practices.
Solid understanding of human anatomy to effectively assess patient needs.
Excellent communication skills for interacting with patients, families, and healthcare teams.
Ability to manage multiple cases simultaneously while maintaining attention to detail.
Knowledge of orthopedic practices is a plus.
Speak fluent Spanish and English
This role requires a compassionate individual who is dedicated to patient care and satisfaction.
Patient Care Coordinator
Patient access representative job in Trevose, PA
Patient Care Coordinator
Department: Patient Support Center/Call Center
Reports To: Sr. Director Operations
FLSA Non-Exempt
Primary Function:
The incumbent is responsible for executing program requirements, managing daily workflow, providing accurate and complete data input, managing pre-certifications, and providing high levels of customer service.
Our core Patient Support Center hours are 8:00am to 11:00pm EST, Monday through Friday, and 8:00am to 8:00pm EST, Saturday and Sunday.
Job Scope and Major Responsibilities:
Complete prescription intake process including verification of insurance coverage
Assist physician's offices through the prior authorization and appeals process
Research financial assistance options for patients through copay cards, foundations, and assistance programs
Coordinate prescription processing and delivery with dispensing pharmacies
Manage and triage high volume of customer service phone calls while managing day to day operations
Build relationships with physicians, manufacturer sales representatives, pharmacies, patients, and other team members to optimize workflow and achieve program goals
Ensure proper documentation of process flow from prescription initiation through completion
Provide timely updates to physicians, pharmacies, and manufacturers regarding prescription status
Interface with IT department to improve system functionality and workflow
Attend team meetings to support ongoing program development
Other responsibilities as assigned
Success in this position is defined by high levels of customer service and timely processing of prescriptions through all phases
Compliance with the provisions of the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations, as amended (“HIPAA”)
Performance Criteria:
Performance in this role is measured by accurate and timely routing of referrals and reporting as well as high levels of customer service.
Required Qualifications:
Minimum of 2 years pharmacy experience preferred
Previous work experience in a call center environment or customer service role preferred
General knowledge of pharmacy laws, practices and procedures
Knowledge of common medical terms/abbreviations and pharmacy calculations
Understanding of insurance and third-party billing systems
Skill to prioritize and work in a fast-paced environment
Exemplary communication, organization, and time management skills
Capability of working independently and as a member of a team
Ability to preserve confidentiality of protected health information (PHI)
Proficient in MS Word, Excel and Outlook
Possess and maintain professional demeanor and courteous attitude
Asembia is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, gender identity and expression, citizenship, genetic disposition, disability or veteran's status or any other classification protected by State/Federal laws
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Auto-ApplyFront Office Coordinator
Patient access representative job in Plainfield, NJ
Benefits:
PTO and other great benefits
Continuous clinical and business training
401(k)
401(k) matching
Bonus based on performance
Competitive salary
Employee discounts
Free uniforms
Health insurance
Paid time off
Training & development
Do you thrive on responsibility, love creating order out of chaos, and have a heart for people? Do you have the confidence, support others, and make patients feel cared for from the very first phone call? If health and wellness are important to you, and you have a passion for helping people improve their lives and health while having fun, this may be the perfect position for you!
We are a fast-paced, upbeat chiropractic and progressive rehab clinic helping patients get back to doing what they love through chiropractic care, progressive rehab (PT), and other wellness services.
If you are energetic, friendly, fun, purpose-driven, motivated, and a team player, we should talk! And because everything in our office moves quickly and there are multiple tasks to be completed, your strong phone, computer, and people skills are all vital.
You'll be involved in many areas of the practice including promotional communications, helping people, customer service, and social media.
You'll enjoy great pay, the opportunity to earn monthly bonuses, and benefits!
Who you are:Do you have a gift for meeting new people and getting them to like you?
Do people look to you first for help because they know it will get done?
Are you quick to smile and have contagious enthusiasm?
Do you derive a great deal of pleasure and strength from developing professional relationships with clients?
Do you have a conscientiousness for doing things right and following tasks through to completion?
What you will do:
Greet and help check in patients
Schedule patients
Answer phones
Make product and supplement recommendations based on the doctor's treatment plan
Scan incoming insurance EOBs
Assist with marketing campaigns, creative content, community outreach
Weekly patient reporting
Verifying patient benefits and insurances
Maintain confidentiality as it pertains to HIPAA guidelines
Work with the rest of the team to keep the clinic clean and clutter-free
Manage patient flow between Doctor, Rehab, and Front Desk to ensure Patient experience is efficient, fun, and effective
Maintain patient accounts by obtaining, recording, and updating personal and financial information
Collect patient charges, control credit extended to patients, and file, collect, and expedite third-party claims
Maintain business office inventory
Other Administrative tasks
What you need
Two-year degree or more is preferred but not required
Previous experience in customer service must be demonstrated
Proficiency in Microsoft Office and Windows is required
If you feel you would be a great fit in our office please apply! Hours are Monday 8am-6:30pm, Tuesday 9:30am-6:30pm, Wednesday 1:30pm-6:30pm, Thursday 8am-6:30pm, Friday 8am-12pm. We look forward to speaking with you! Compensation: $18.00 - $21.00 per hour
WHAT WE DO:
At HealthSource Chiropractic, we don't just focus on chiropractic care-we prioritize the patient experience with a special emphasis on personalized care and well-being. We offer state of the art chiropractic treatments, personalized care plans, and holistic wellness services. When patients come to our clinic, they gain the power to reclaim their health and to get back to doing what they love- pain free.
We offer comprehensive training and support to help our team succeed. To learn more about our exciting opportunity and then take the next step toward becoming a HealthSource team member today, simply contact us for more information.
JOIN THE HEALTHSOURCE TEAM AND…
Be a part of the ever-growing team focused on blending personalized and customized chiropractic and wellness care- in order to provide each patient with a unique treatment care plan!
Access ongoing support and join a community of chiropractors, rehab specialists, billing specialist, and front desk specialists to enhance your skills and advance your career.
Build a rewarding career with substantial earning potential
Experience a practice environment that feels like home, with colleagues who feel like family.
Spend your days in a professional, inviting clinic and foster meaningful connections with patients.
Help patients achieve optimal health and wellness each day.
Auto-ApplyBilingual Patient Advocate, Educator
Patient access representative job in Cherry Hill, NJ
Bilingual Patient Advocate, Educator - Full-Time
Gain valuable experience thru meaningful interactions with patients in the inspiring field of abortion care
Motivated Patient Advocate / Educator / Center Assistant sought for Full-Time Tuesday through Saturday hours at Cherry Hill Women's Center, a state licensed ambulatory surgical center. CHWC has delivered excellence in abortion and reproductive healthcare for over 45 years, always at the forefront of best practices in our field. Our team members are committed to advocating and caring for women seeking legal, safe, compassionate abortion care, in addition to assistance for adoption services and prenatal care.
Patient Advocate, Education and Lab Responsibilities include:
Responding to patient needs by offering fact-based education, supportive counseling and community resources discussed in a patient-centered manner and include parenting and adoption plans
Serving as an advocate to patients, their partners and families, providing referrals when necessary
Bilingual Advocates interpret for non-English speaking patients and their loved ones throughout the abortion care experience
Cross training on Front Desk Receptionist and Financial Intake includes:
Performing patient check-in
Meeting with patients to collect payments, dealing with all insurance and payment issues and working with outside organizations to secure funding for patients
Reconciling deposits and completing all required tracking paperwork
Participation in training of interns
Our team welcomes committed individuals with a strong work ethic, who want to make a difference in the community, work with a diverse patient population and can juggle multiple tasks.
Ideal candidates possess:
Staff members who speak more than one language interpret for non-English speaking patients and their loved ones throughout their experience.
Effective communication skills
Strong computer skills (Electronic Health Record experience a plus!)
Ability to multitask, strong attention to detail and excellent time management skills
General knowledge of reproductive systems
CHWC is committed to continuous improvement and we believe that all people must have access to high quality, compassionate and respectful reproductive healthcare. CHWC is an active member of the Abortion Care Network and accredited by the National Abortion Federation and American Association for Accreditation of Ambulatory Surgery Facilities and licensed by NJ Department of Health. CHWC values staff development and growth and offers many learning opportunities at national conferences.
Full-Time hours Tuesday through Saturday - no nights - no holidays
Benefits: competitive pay rate, medical, dental, vision, life, Aflac, 401k with employer match.
Auto-ApplyMedicaid/CharityCare Eligibility Representative
Patient access representative job in East Windsor, NJ
The KA Consulting Services division of Panacea has been assisting hospitals and healthcare systems with the intricacies of reimbursement since 1978. Throughout our history, we have focused on helping our clients navigate the complexity of both governmental and commercial-payment models with the dual goals of optimizing revenue and achieving compliance. Our extensive knowledge base and years of industry experience provide a blueprint for clinical decision making, data analysis, and documentation - the backbone for a successful hospital or health system.
Panacea Healthcare Solutions is looking for a Medicaid/CharityCare Eligibility Representative to work at our client facilities with patients applying for financial assistance.
Requirements
Essential Job Functions and Primary Duties:
Assisting patients in applying for financial assistance through Medicaid or Charity Care on behalf of our client facility.
Interviewing patients or authorized representatives via phone or in person to gather information to determine eligibility for medical benefits.
Obtaining, verifying, and calculating income and resources to determine client financial eligibility.
Documenting case records using automated systems to form a record for each client.
Following up with applicants to obtain accurate and complete information within strict timeframes.
Completing/following up on all forms related to Medicaid and Charity Care eligibility.
Performing any additional tasks related to the position assigned by the Manager.
Minimum Qualifications:
High school diploma/GED, Bachelor's degree is preferred.
Must be ambitious and self-directed in a fast-paced environment and can perform in a high volume, multitasking setting.
Must be trustworthy, professional, detail and goal oriented.
Must have exceptional customer service and excellent verbal/written communication skills.
Must be able to learn and work with Medicaid eligibility regulations.
Preferred Qualifications:
Knowledge of Medicaid and Charity Care program.
Experience working in a hospital setting.
Ability to speak and read Spanish.
Title and Registration Specialist I
Patient access representative job in Freehold, NJ
Dealership:L0622 Northeast Finance Center
Title and Registration Specialist Employment Type: Full-time 8:00-5:00
Drive Your Career Forward with Lithia & Driveway
Freehold BMW is powered by Lithia! Lithia & Driveway (LAD) is a Fortune 500 company and one of the largest automotive retailers in North America, with nearly 450 dealerships across the U.S., Canada, and the U.K. Our Dealership Accounting teams are essential partners in our success, ensuring accuracy, consistency, and compliance across all financial operations. With a strong focus on collaboration, growth, and continuous improvement, we offer the tools and support you need to build a rewarding accounting career in a fast-paced, dynamic environment. Join us and be part of a team where your impact truly drives the business forward.
With a mission of "Growth Powered by People," we are propelled by our colleagues and preferred by our customers, making Lithia & Driveway the leading automotive retailer in each of our markets.
Our success is fueled by four core values:
Earning Customers for Life
Improving Constantly
Taking Personal Ownership
Having Fun
Our entrepreneurial, high-performance culture sets us apart, and our philosophy is straightforward: assemble a team of passionate individuals and cultivate an environment that empowers colleagues to excel.
We'd love to have you join us on our journey.
What You'll Do:
Review and analyze inbound and outbound vehicle title and registration documents for accuracy and submit them to the appropriate government agencies.
Research and resolve vehicle title issues for both purchased and sold vehicles that have aged beyond 15 or 30 days respectively.
Communicate directly with customers via chat, phone, and email to resolve registration/title issues and answer questions about purchase paperwork.
Work directly with government personnel when needed to resolve registration or title discrepancies.
Follow up with internal LAD personnel to correct issues identified during the purchase or sale process.
Meet company-established benchmarks for accuracy, timeliness, cure rates, and efficiency.
Apply effective strategies to diagnose and resolve administrative and occasionally complex issues in a timely manner.
Perform additional tasks and responsibilities as needed to support the title and registration function.
What You'll Bring:
Strong attention to detail - essential for reviewing and processing title and registration documents accurately.
Excellent communication skills - for interacting with customers, internal teams, and government personnel.
Time management - to meet deadlines and performance standards.
Active listening - to understand and resolve customer and administrative issues effectively.
Critical thinking - for diagnosing and resolving both routine and complex title/registration problems.
Ability to work independently - especially important in a role that requires self-motivation and accountability.
Experience: 1+ years of experience in a vehicle dealership and/or processing vehicle registration paperwork is preferred.
Notary helpful but not required.
We Offer Best-in-Class Industry Benefits:
Competitive pay between $22-25 per hour depending on experience
Medical, Dental, and Vision Plans starting after 30 days
Paid Holidays & PTO
Short and Long-Term Disability
Paid Life Insurance
401(k) Retirement Plan
Employee Stock Purchase Plan
Lithia Learning Center
Vehicle Purchase Discounts
Wellness Programs
Qualifications:
High School graduate or equivalent required
18 years or older
We are a drug-free workplace
If you are ready for a change, if you are ready to learn more, grow more and do more than you've ever done before, apply today.
We are committed to equal employment opportunity (regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status). We also consider qualified applicants regardless of criminal histories, consistent with legal requirements.
Auto-ApplyBilingual Patient Advocate, Educator
Patient access representative job in Cherry Hill, NJ
Bilingual Patient Advocate, Educator - Full-Time
Gain valuable experience thru meaningful interactions with patients in the inspiring field of abortion care
Motivated Patient Advocate / Educator / Center Assistant sought for Full-Time Tuesday through Saturday hours at Cherry Hill Women's Center, a state licensed ambulatory surgical center. CHWC has delivered excellence in abortion and reproductive healthcare for over 45 years, always at the forefront of best practices in our field. Our team members are committed to advocating and caring for women seeking legal, safe, compassionate abortion care, in addition to assistance for adoption services and prenatal care.
Patient Advocate, Education and Lab Responsibilities include:
Responding to patient needs by offering fact-based education, supportive counseling and community resources discussed in a patient-centered manner and include parenting and adoption plans
Serving as an advocate to patients, their partners and families, providing referrals when necessary
Bilingual Advocates interpret for non-English speaking patients and their loved ones throughout the abortion care experience
Cross training on Front Desk Receptionist and Financial Intake includes:
Performing patient check-in
Meeting with patients to collect payments, dealing with all insurance and payment issues and working with outside organizations to secure funding for patients
Reconciling deposits and completing all required tracking paperwork
Participation in training of interns
Our team welcomes committed individuals with a strong work ethic, who want to make a difference in the community, work with a diverse patient population and can juggle multiple tasks.
Ideal candidates possess:
Staff members who speak more than one language interpret for non-English speaking patients and their loved ones throughout their experience.
Effective communication skills
Strong computer skills (Electronic Health Record experience a plus!)
Ability to multitask, strong attention to detail and excellent time management skills
General knowledge of reproductive systems
CHWC is committed to continuous improvement and we believe that all people must have access to high quality, compassionate and respectful reproductive healthcare. CHWC is an active member of the Abortion Care Network and accredited by the National Abortion Federation and American Association for Accreditation of Ambulatory Surgery Facilities and licensed by NJ Department of Health. CHWC values staff development and growth and offers many learning opportunities at national conferences.
Full-Time hours Tuesday through Saturday - no nights - no holidays
Benefits: competitive pay rate, medical, dental, vision, life, Aflac, 401k with employer match.
Auto-ApplyPatient Services Technician Specialist/ Phlebotomist
Patient access representative job in Medford, NJ
Exhibit proficiency in all of the following: blood collection by venipuncture and capillary technique from patients of all age groups, urine drug screen collections, paternity collections, breath/saliva alcohol testing, LCM/Cyber Tools, TestCup, pediatric blood collections, difficult draws (patients in mental retardation facilities, long-term care facilities, drug rehabilitation facilities, prisons, psychiatric facilities, or similar facilities).
Additional Information
For any queries please call me back @ ************
Thank you,
Patient Representative I
Patient access representative job in Somerville, NJ
The Patient representative (PR) acts as a greeter to patients entering Zufall Health Center as well answer the telephone, complete registration, and conduct intake as needed. The PR directs patients to the appropriate destination, answers questions, and explains processes, as well as
reviews required documentation and checks eligibility. Most importantly, the PR supports the
mission and vision of the Zufall Health Center.
Essential Functions, Duties and Responsibilities
* Consistently adheres to all departmental policies and procedures
* Conducts all aspects of job in a professional and ethical manner
* Works independently with little or no supervision but uses available resources for problem resolution as indicated by circumstances or need
* Completes assignments in a timely and efficient manner.
* Maintains high level of confidentially.
* Works collaboratively with team members to assure the optimal outcomes of care and service.
* Utilizes departmental resources prudently and appropriately.
* Uses communication methods which create and foster a positive image of the department, upholding the values of the Zufall Health Center.
* Communicates appropriately both verbally and in writing; uses appropriate mechanisms for identifying and resolving work related issues.
* Keeps manager or supervisor informed of work related issues at all times.
* Performs additional duties as determined by supervisor.
Specific Duties
Interaction with Patients
* Greets all visitors to the facility and directs them to their appropriate destination.
* Greets patients and visitors in a prompt, pleasant, and helpful manner in person and on the telephone.
* Answers the telephone and makes appointments or responds to inquiries.
* Ensures that the patient brings all supporting documentation to visit.
* Reminds patient of appointment time, documentation needed, immunization records for new patient pediatric appointments, and schedules and re-schedules appointments.
* Explains processes and forms to patients as needed.
* Conducts eligibility checks on insurances.
* Collects payments from patients, enters the payment in eCW and prints receipts for patient. PR's are responsible for the money they collect and ensuring that it is locked in the safe or locked drawer at their desk or in supervisor's office at all times. Keys to drawers are never to be left in the open.
* Communicates with the medical staff regarding patient's visits.
* Assists with printing out requisitions or other forms as needed.
* As PR's are in the public areas, they should present themselves always as professional and friendly, and act as a team player in all situations. They are responsible for keeping their personal areas and their surrounding public areas neat and clean and should routinely "straighten up" during the day.
* Appearance of attire and possessions: PR's should keep their "scrubs" that they wear in good condition, clean and neat. Only Zufall jackets are to be worn over scrubs. Wearing of personal sweaters or sweatshirts are not allowed. Only white T shirts are allowed under scrubs and clean sneakers are to be worn. No personal clothing or possessions are to be visible at their desk or on the back of the chair. This includes cell phones which should never be taken out, for any reason in an area where patients are allowed, regardless of whether or patients or visitors are present.
* PR's are hired as a PR I. They remain at this level during their initial training and after three months of employment are required to take an exam which covers all of the material that is required to perform their duties. It includes but is not limited to customer satisfaction, telephone encounters, refill processes, insurances, registration of patients, special population definitions, HIPAA, compliance and Zufall policies and procedures.
* Staff will have three opportunities to pass the exam. If they do not pass at their first or second try they will be given additional training. If however, they fail three times, they will be terminated.
Communication
* Maintains patients' confidentiality in compliance with HIPAA and other federal, state and local regulations as stated in the ZHC policies and procedures manual.
* Answers inquiries of patients and public in person or via telephone regarding regulations and services; when necessary, refers inquiries to appropriate person or department.
* Reads, writes, speaks, understands, and communicates in English and Spanish sufficiently to perform the duties of this position.
Requirements
* Has knowledge of computer software programs such as Microsoft Word, and electronic medical records.
* Have excellent customer service skills.
* Be able to work with very little supervision.
* Be able to adapt quickly to unanticipated changes in work flow or work process, or frequent
* changes in insurances rules and coverage changes.
* Be able to understand, carry out, and remember verbal and written instructions.
* Bilingual English and Spanish required.
Education, Training and Experience
* High School diploma required; college credit or additional education in medical field or insurance and billing courses preferred
* Possess a current, unrestricted New Jersey operator license issued by the New Jersey Division of
* Motor Vehicles, or be able to efficiently and effectively use public transportation in order to be able to travel to other sites as needed.
* Have minimum of 1 year experience in customer service field, and 1 year of experience in collecting money or billing and insurances.
* Experience in a clinical/ambulatory care setting preferred
Salary Description
$16.00-$18.55 per hour
Insurance Verification Specialist
Patient access representative job in Lakewood, NJ
Department: Care Access Reports To: Manager of Care Access FLSA Status: Exempt
BrightSpan Health is seeking an Insurance Verification Specialist. The Insurance Verification Specialist is responsible for verifying patient insurance coverage and benefits by directly contacting insurance payers to obtain accurate and up-to-date information. This role ensures that insurance eligibility, coverage limitations, co-pays, deductibles, and authorization requirements are clearly determined and documented prior to services being rendered, contributing to a smooth patient experience and efficient claims processing.
What you can expect
Initiate and conduct outbound calls to insurance payers to confirm patient eligibility, plan details, and coverage for specific services, including procedures, diagnostics, and office visits.
Obtain and verify insurance information, including policy effective dates, plan types, network participation, benefit levels, co-pays, coinsurance, and deductibles.
Identify and document prior authorization or referral requirements for services scheduled and communicate these to the appropriate internal teams for action.
Accurately enter insurance details and benefits information into the electronic health record (EHR) or practice management system, ensuring all fields are complete and up-to-date.
Monitor and track insurance changes, payer updates, and benefit policy revisions, communicating relevant updates to internal stakeholders.
Resolve discrepancies in insurance information by coordinating with patients, insurance representatives, and internal teams.
Maintain compliance with HIPAA regulations, organizational standards, and payer-specific requirements when handling patient information and insurance data.
Support other revenue cycle or patient access activities, including assisting with prior authorizations, as needed.
What you'll need
High school diploma or equivalent required; associate's degree or coursework in healthcare administration, medical billing, or related field preferred.
Minimum of 1-2 years of experience in insurance verification, benefits coordination, or related healthcare administrative work.
Thorough knowledge of medical insurance plans, terminology, and payer benefit structures (including commercial, Medicaid, and Medicare plans).
Proficient in the use of EHRs and payer portals, with strong computer and data entry skills.
Excellent verbal and written communication skills, with the ability to speak professionally with patients, payers, and internal teams.
Detail-oriented and organized, with the ability to handle multiple tasks and deadlines in a fast-paced environment.
Knowledge of HIPAA regulations and patient privacy standards.
It'd be a plus if you had
Experience with prior authorization or pre-certification processes.
Familiarity with CPT, ICD-10, and HCPCS codes.
Bilingual abilities (especially Spanish) a plus.
Experience in specialty or multi-site healthcare settings.
Why BrightSpan?
Competitive compensation among our industry competitors;
Medical, dental and vision insurance;
FSA & HSA plans available;
Paid time off and holidays;
Opportunities for professional and career development in a growing organization;
Patient Services Coordinator
Patient access representative job in Langhorne, PA
Job Description
IVIRMA North America network of state-of-the-art fertility clinics is currently seeking hard-working, reliable and motivated people for our front desk role in our Langhorne PA location. The Front Desk/Patient Services Coordinator will be responsible for greeting patients, activating patient files, and for providing support to patients and medical staff. This is a full-time position Monday-Friday from 6:45am-3:45pm or 7am-4pm, with weekend rotation.
The Patient Services Coordinator will greet all incoming patients and guide them through their visit. This role will set the tone for the patient's visit and coordinate each phase with the necessary departments. They resolve problems by working in concert with members of our multi-disciplinary teams to present a positive practice image to our patients.
Essential Functions and Accountabilities:
Welcomes and greets all patients and visitors.
Comforts patients by anticipating their anxieties and answering their questions.
Follows provider appointment templates and guides patients through their visit.
Assesses schedule conflicts and problems with recommendations for solutions.
Collects payments as required; works with Finance to ensure all insurance information is entered and up to date.
Works closely with patient's care team to coordinate total patient care.
Processes medical records requests.
Handles administrative tasks such as filing, sorting faxes, and answering phones.
Schedules and confirms appointments.
Works with other departments to ensure the office is in excellent condition.
Supports office by ordering supplies and maintaining the front desk and waiting room areas.
Academic Training:
High School Diploma or equivalent (GED) -
required
Associate's degree -
a plus
Area:
Administrative Management or other related field
Position Requirements/Experience:
1+ years practical experience working in a similar position
Experience in a patient-facing role - preferred
Experience working in medical/healthcare industry
2+ years practical experience working in a customer service setting
Technical Skills:
Proficient computer skills (Microsoft Office). Keyboard skills of 25 words required. Experience with medical office software program(s) (EMR's) preferred.
IVI-RMA offers a comprehensive benefits package to all employees who work a minimum of 30 hours per week. (This may not be offered for temporary employment)
Medical, Dental, Vision Insurance Options
Retirement 401K Plan
Paid Time Off & Paid Holidays
Company Paid: Life Insurance & Long-Term Disability & AD&D
Flexible Spending Accounts
Employee Assistance Program
Tuition Reimbursement
About IVIRMA Global:
IVIRMA is the largest group in the world devoted exclusively to human Assisted Reproduction Technology. Along with the great privilege of providing fertility care to our patients, IVIRMA embraces the great responsibility of advancing the field of human reproduction. IVIRMA Innovation, as one of the pillars of IVIRMA Global, is a renowned leader in fertility research and science. Check out our websites at: *********************** & ***********************
EEO
“IVIRMA is an Equal Opportunity Employer and Prohibits Discrimination and Harassment of Any Kind: IVIRMA is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment. All employment decisions at IVIRMA are based on business needs, job requirements and individual qualifications, without regard to race, color, religion and/or belief, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. IVIRMA will not tolerate discrimination or harassment based on any of these characteristics. IVIRMA encourages applicants of all ages.”
Dental Front Office Coordinator
Patient access representative job in Medford, NJ
Dental Front Office Coordinator - Medford Dental Arts, Medford NJ (Formerly Dr. Euksuzian & Dr. Braatz Family and Cosmetic Dentistry)
Medford Dental Arts proudly champions a patient-centric approach, fostering exceptional patient experiences, top-notch employee and dentist retention, and remarkable practice growth. You will thrive in an efficient office environment alongside an exceptional, well-trained, highly motivated dental team where you can expand your knowledge and career. We welcome you to join us if you are drawn to working in a clinically- focused, patient-centric, fully digital dental office. Apply today and be part of our exciting journey!
Schedule: Monday / Thursday: 8:30AM - 7:00PM, Tuesday: 8:30AM - 5:00PM, Friday: 8:30AM - 5:00PM
Overview
We are looking for a motivated, resourceful, customer-driven individual to join our team as a Front Office Coordinator. This position serves as a welcoming presence to all patients, vendors, and guests while offering day-to-day expertise in practice-level functions. This role is provided direction and responsibility for various administrative and clinical tasks daily and is assigned those responsibilities by the Practice Leader.
Duties/Responsibilities
Maintain meticulous records to ensure all provider, insurance, and patient accounts are recorded and posted correctly.
Schedule and confirm patient appointments to maximize the provider schedules.
Present treatment plans and financial responsibilities effectively to patients.
Address patient concerns while remaining calm, effective, and even-tempered in high-pressure circumstances.
Maintain a positive and professional image, both individually and within the workspace.
Consistently meet the expectations and responsibilities of the Practice Leader and practice needs.
Assist and support clinical team as needed in areas such as set up/break down of dental operatory and instrument sterilization.
Other assigned duties and responsibilities per management.
Required Skills/Abilities
Dental office experience preferred.
Dentrix experience strongly preferred.
Excellent oral and written communication skills.
Adhere to OSHA guidelines, HIPAA Privacy Policy, and operating procedures.
Facility with Microsoft Office and dental practice management software.
Positively contribute to a respectful and collaborative working environment with coworkers.
Facilitate patient comfort, care, and satisfaction consistently.
Willingness to advance skills through continuing education opportunities.
Present to work during scheduled shifts.
Education and Experience
High School Degree.
Prior front desk experience in a medical or dental office.
People management or staff/ project coordination experience.
Physical Requirements
Prolonged periods sitting at a desk and working on a computer.
Prolonged periods of periods of standing and bending.
Must be able to lift
Benefits for Full-Time Employees*
PTO, paid holidays, office closure days
Medical
Vision
Dental allowance
Uniform allowance, as needed
401(k) Eligibility
And many more!
*Benefits are subject to change and eligibility*
The pay range for this role varies based on experience, credentials, and availability. In addition to competitive compensation, our team members enjoy continuing education opportunities, production-based incentives (when applicable), and clear pathways for growth within the practice.
Our Mission & Values: To make the teams, patients, and practices we support healthier and happier.
Auto-ApplyPatient Success Specialist
Patient access representative job in Englishtown, NJ
Job DescriptionJob Summary/Objective The Patient Success Specialist plays a critical role in supporting patients facilitating the conversion of prescriptions to filled medications. This role provides patient education to ensure timely and successful therapy initiation. The ideal candidate is empathetic, detail-oriented, and passionate about improving patient outcomes. This role will communicate directly with patient and clients, with a focus on collaboration, ability to adapt to client needs, listening, and providing support externally and internally.
Key Responsibilities
Provides outbound call outreach to patients who begin the prescription fulfillment process
Acts as the first point of contact for DTC patient inquiries, concerns, and requests, ensuring a prompt and reliable response
Serve as the primary point of contact for patients to guide them through the prescription fulfillment process
Proactively follow up with patients to ensure prescriptions are filled and therapy is started
Collaborate with prescribers and pharmacy to resolve barriers to medication access if needed
Track patient fulfillment progress, documenting interactions, and escalating issues as needed
Maintain accurate and timely records of patient communications, prescription status, and outcomes
Researches and resolves customer inquires
Identify and address common reasons for prescription abandonment or delays
Utilize CRM and other internal systems to manage patient workflows and ensure compliance with SOPs
Communicate effectively with internal teams to coordinate support and share patient insights
Monitor and report on conversion metrics and patient engagement trends
Uphold patient confidentiality and comply with HIPAA and other regulatory requirements
Adheres to clients' Business Rules, SOPs and regulations (i.e., PDMA) requirements for assigned tasks
Maintains working knowledge of products and/or services
Cross train on client programs and be willing to perform back up responsibilities
Must have the ability to toggle between applications simultaneously
Strong ability to multitask; manage multiple projects effectively, handle distractions well, adaptable to new responsibilities
Employs effective oral and written communication skills to ensure appropriate error mitigation communication
Utilizes organizational skills to prioritize deliverables to accomplish work in established timeframes.
Proactively identify innovative ways to accomplish tasks and drive toward process efficiencies.
Other duties as assigned
Qualifications /Skills
High School diploma required, associate degree preferred
3+ years of customer-facing role experience, preferably handling patient service and/or patient care. Experience in healthcare, pharmacy, patient support, or case management preferred
Proficiency in using a CRM platform
Proficiency in using Microsoft Office, particularly Word, Excel, and Outlook.
Professional verbal and written communication skills including grammar, spelling, punctuation, etc.
Friendly and empathetic demeanor.
Strong interpersonal skills and professional presentation.
Strong organizational and prioritization skills with the ability to pay close attention to details.
Ability to adapt to changing situations.
Strong follow-through on projects and duties.
Ability to deal with frequent change, delays or unexpected events and the capability to adapt to changes in the work environment and manage competing demands.
Salary Range: $41,500 - $48,000 annually, depending on experience and qualifications. Benefits Overview:
Medical, dental, and vision insurance
401(k) retirement plan with employer match
Paid time off (vacation, sick leave, holidays)
Parental leave
Medvantx is an equal opportunity employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related conditions), sexual orientation, gender identity, gender expression, age, veteran or disability status, or other protected characteristics.
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Billing and Collections Specialist
Patient access representative job in Trenton, NJ
Henry J. Austin Health Center delivers person-centered, high-quality health care. Working with our community partners, our exceptional team provides trauma-informed, holistic care to maximize individuals' strengths and abilities to achieve optimal health and well-being.
Henry J. Austin Health Center is an Equal Opportunity Employer (EOE) and Federally Qualified Health Center (FQHC). FQHC is a federal designation from the Bureau of Primary Health Care (BPHC) and the Center for Medicare and Medicaid Services (CMS) that is assigned to private non-profit or public health care organizations that serve predominantly uninsured or medically underserved populations. FQHCs are located in or serving a federally designated Medically Underserved Area.
Qualified applicants are considered for employment without regard to age, race, creed, color, national origin, ancestry, marital status, civil union, domestic partnership, affectional or sexual orientation, genetic information, sex, gender identity, disability or veteran status. Henry J. Austin Health Center is an accessible and equitable employer.
Billing and Collections Specialist
Trenton, NJ
Full Time
Entry Level
Share
Starting at $47,840
On-site position
MAJOR FUNCTION
This position collaborates closely with the Revenue Cycle Manager & Revenue Cycle Supervisor, to ensure the seamless execution of day-to-day operations within the Billing Department. With a focus on detail and accuracy, the Billing and Collections Specialist will work to ensure the timely of provider encounters for submission to insurance companies. They will also work with the Revenue Cycle Specialist and revenue cycle vendor(s) to research and resolve billing issues.
ESSENTIAL FUNCTIONS
* Billing and Claims Management:
* Prepare and submit accurate and timely medical claims to insurance companies or government programs (e.g., Medicare, Medicaid).
* Verify insurance eligibility and benefits for patients, as needed.
* Assist with claims follow-up to promptly resolve billing discrepancies and denials.
* Collaborate with healthcare providers and relevant department staff to resolve billing discrepancies.
* Revenue Cycle Management:
* Monitor accounts receivable to ensure timely payment and reduce aging of accounts.
* Process payments, adjustments, and refunds accurately.
* Reconcile billing discrepancies and resolve billing issues.
* Works with the Patient Access department (Medical and/or Dental) to resolve billing and registration issues.
* Compliance and Documentation:
* Maintain compliance with coding and billing regulations, including HIPAA, CPT coding guidelines, and local coverage determinations.
* Ensure timely and accurate submissions for Medicare and Medicaid WRAP billing and NJ Letter of Agreement (LOA) billing.
* Revenue Analysis and Reporting:
* Generate and analyze reports related to billing, collections, and revenue cycle metrics.
* Identify trends, discrepancies, or areas for improvement in the billing process.
* Provide regular updates to management on billing and collection activities.
ADDITIONAL RESPONSIBILITIES:
* Works closely with Revenue Cycle Manager, Supervisor and/or Director to establish priorities in duties/responsibilities
* Works closely with the Revenue Cycle Specialist with the goal of maximizing revenue for HJAHC.
* Manage relationships with outsourced revenue cycle vendor(s).
* Attend Medical Staff meetings and deliver special presentations as needed.
* Collaborate with all employees to achieve Henry J. Austin Health Center's goals and objectives, following established policies and procedures.
* Demonstrate willingness and flexibility to perform tasks and projects assigned in the Finance Department.
* Stay updated on healthcare regulations and reimbursement trends to optimize revenue generation.
* Assist in training new staff members on revenue cycle processes and procedures as needed.
* Ability to keep up with multiple deadlines, project goals, and to keep up with high volume of work.
* Performs any additional duties as may be assigned by supervisor, manager or director.
* Works on special projects as needed/assigned.
* Duties, responsibilities and activities may change, or new ones may be assigned at any time with or without notice.
PREREQUISITES:
* Minimum of 2-3 years of billing experience required in a healthcare setting.
* Minimum of 4-5 years of experience in FQHC settings preferred with an understanding of the workings of City, State and Federal assistance programs such as LOA, HRSA, and Grants.
* Proficiency in Athena EHR system preferred.
LICENSURE AND/OR CERTIFICATIONS
* Organization reserves the right to request certifications and/or licensures as needed.
EDUCATION & EXPERIENCE:
* High School Diploma required, bachelor's degree preferred, or some college combined with equivalent experience.
* Proficiency in using Electronic Health Records (EHR) and billing software (Athena Preferred).
* Proficient in word processing and skilled in utilizing Excel and its functionalities.
* Knowledge of medical terminology
* Provider billing and collections experience (3 years) with an understanding of medical insurances ie; Medicare, Medicaid, Managed Care, and Commercial insurances, and a thorough understanding of medical insurance billing basics, ie; charges, allowed amounts, payments, adjustments, denials, capitation, eligibility, coordination of benefits.
KNOWLEDGE, SKILLS, ABILITIES AND OTHER (KSAO's)
* Knowledge: Understanding of healthcare billing practices, compliance regulations, and reimbursement methodologies, preferably for FQHC's. Understanding of the workings of City, State and Federal assistance programs such as LOA, HRSA, and Grants.
* Skills: Strong analytical skills, attention to detail, and proficiency in Microsoft Office Suite (Excel, Word). Excellent writing skills with the ability to present high level data and information to senior level staff. Ability to use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
* Abilities: Ability to multitask, prioritize workload, follow through on tasks and work independently as well as part of a team. Must be willing to take ownership of work deliverables to ensure assignments/projects are met in a timely fashion. Ability and willingness to meet critical deadlines. Ability to independently set and achieve goals. Ability to use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
* Other: Strong communication skills, adept in both verbal and written forms. Committed to upholding patient confidentiality and delivering exceptional customer service. Skilled in fostering and maintaining effective working relationships with colleagues. Bilingual proficiency preferred. Demonstrates recognition and respect for cultural diversity. Adheres to dress code standards with a neat and clean appearance. Diligently attends annual reviews and departmental in-services as scheduled.
PHYSICAL & WORK REQUIREMENTS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This position requires manual dexterity sufficient to operate phones, computers and other office equipment. The position requires the physical ability to kneel, bend, and perform light lifting. This person must have the ability to write and speak clearly using the English language to convey information and be able to hear at normal speaking levels both in person and over the telephone. Specific vision abilities required by this job include close vision, depth perception and the ability to adjust focus. Generally, the working conditions are good with little or no exposure to extremes in health, safety hazards and/or hazardous materials.
Patient Services Technician Specialist/ Phlebotomist
Patient access representative job in Burlington, NJ
Exhibit proficiency in all of the following: blood collection by venipuncture and capillary technique from patients of all age groups, urine drug screen collections, paternity collections, breath/saliva alcohol testing, LCM/Cyber Tools, TestCup, pediatric blood collections, difficult draws (patients in mental retardation facilities, long-term care facilities, drug rehabilitation facilities, prisons, psychiatric facilities, or similar facilities).
Additional Information
For any queries please call me back @ ************
Thank you,
Billing and Collections Specialist
Patient access representative job in Trenton, NJ
Starting at $47,840 MAJOR FUNCTION This position collaborates closely with the Revenue Cycle Manager & Revenue Cycle Supervisor, to ensure the seamless execution of day-to-day operations within the Billing Department. With a focus on detail and accuracy, the Billing and Collections Specialist will work to ensure the timely of provider encounters for submission to insurance companies. They will also work with the Revenue Cycle Specialist and revenue cycle vendor(s) to research and resolve billing issues.
ESSENTIAL FUNCTIONS
Billing and Claims Management:
Prepare and submit accurate and timely medical claims to insurance companies or government programs (e.g., Medicare, Medicaid).
Verify insurance eligibility and benefits for patients, as needed.
Assist with claims follow-up to promptly resolve billing discrepancies and denials.
Collaborate with healthcare providers and relevant department staff to resolve billing discrepancies.
Revenue Cycle Management:
Monitor accounts receivable to ensure timely payment and reduce aging of accounts.
Process payments, adjustments, and refunds accurately.
Reconcile billing discrepancies and resolve billing issues.
Works with the Patient Access department (Medical and/or Dental) to resolve billing and registration issues.
Compliance and Documentation:
Maintain compliance with coding and billing regulations, including HIPAA, CPT coding guidelines, and local coverage determinations.
Ensure timely and accurate submissions for Medicare and Medicaid WRAP billing and NJ Letter of Agreement (LOA) billing.
Revenue Analysis and Reporting:
Generate and analyze reports related to billing, collections, and revenue cycle metrics.
Identify trends, discrepancies, or areas for improvement in the billing process.
Provide regular updates to management on billing and collection activities.
ADDITIONAL RESPONSIBILITIES:
Works closely with Revenue Cycle Manager, Supervisor and/or Director to establish priorities in duties/responsibilities
Works closely with the Revenue Cycle Specialist with the goal of maximizing revenue for HJAHC.
Manage relationships with outsourced revenue cycle vendor(s).
Attend Medical Staff meetings and deliver special presentations as needed.
Collaborate with all employees to achieve Henry J. Austin Health Center's goals and objectives, following established policies and procedures.
Demonstrate willingness and flexibility to perform tasks and projects assigned in the Finance Department.
Stay updated on healthcare regulations and reimbursement trends to optimize revenue generation.
Assist in training new staff members on revenue cycle processes and procedures as needed.
Ability to keep up with multiple deadlines, project goals, and to keep up with high volume of work.
Performs any additional duties as may be assigned by supervisor, manager or director.
Works on special projects as needed/assigned.
Duties, responsibilities and activities may change, or new ones may be assigned at any time with or without notice.
PREREQUISITES:
Minimum of 2-3 years of billing experience required in a healthcare setting.
Minimum of 4-5 years of experience in FQHC settings preferred with an understanding of the workings of City, State and Federal assistance programs such as LOA, HRSA, and Grants.
Proficiency in Athena EHR system preferred.
LICENSURE AND/OR CERTIFICATIONS
Organization reserves the right to request certifications and/or licensures as needed.
EDUCATION & EXPERIENCE:
High School Diploma required, bachelor's degree preferred, or some college combined with equivalent experience.
Proficiency in using Electronic Health Records (EHR) and billing software (Athena Preferred).
Proficient in word processing and skilled in utilizing Excel and its functionalities.
Knowledge of medical terminology
Provider billing and collections experience (3 years) with an understanding of medical insurances ie; Medicare, Medicaid, Managed Care, and Commercial insurances, and a thorough understanding of medical insurance billing basics, ie; charges, allowed amounts, payments, adjustments, denials, capitation, eligibility, coordination of benefits.
KNOWLEDGE, SKILLS, ABILITIES AND OTHER (KSAO's)
Knowledge: Understanding of healthcare billing practices, compliance regulations, and reimbursement methodologies, preferably for FQHC's. Understanding of the workings of City, State and Federal assistance programs such as LOA, HRSA, and Grants.
Skills: Strong analytical skills, attention to detail, and proficiency in Microsoft Office Suite (Excel, Word). Excellent writing skills with the ability to present high level data and information to senior level staff. Ability to use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
Abilities: Ability to multitask, prioritize workload, follow through on tasks and work independently as well as part of a team. Must be willing to take ownership of work deliverables to ensure assignments/projects are met in a timely fashion. Ability and willingness to meet critical deadlines. Ability to independently set and achieve goals. Ability to use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
Other: Strong communication skills, adept in both verbal and written forms. Committed to upholding patient confidentiality and delivering exceptional customer service. Skilled in fostering and maintaining effective working relationships with colleagues. Bilingual proficiency preferred. Demonstrates recognition and respect for cultural diversity. Adheres to dress code standards with a neat and clean appearance. Diligently attends annual reviews and departmental in-services as scheduled.
PHYSICAL & WORK REQUIREMENTS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This position requires manual dexterity sufficient to operate phones, computers and other office equipment. The position requires the physical ability to kneel, bend, and perform light lifting. This person must have the ability to write and speak clearly using the English language to convey information and be able to hear at normal speaking levels both in person and over the telephone. Specific vision abilities required by this job include close vision, depth perception and the ability to adjust focus. Generally, the working conditions are good with little or no exposure to extremes in health, safety hazards and/or hazardous materials.
Auto-Apply