Patient Access Representative II Patient Access Services Pennington NJ

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

Pay Range: $18.57 - $23.23
Scheduled Weekly

Hours:

40
Full‑time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part‑time).

Registers patients accurately, efficiently, and independently to ensure database integrity. Maintains financial integrity of all front‑end registration and insurance verification functions while upholding the utmost in customer satisfaction. Applies all financial screening guidelines and maintains up‑to‑date knowledge and adheres to all payors and regulatory guidelines for medical insurance claims for processing and reimbursement. Develops and maintains solid relationships with physician offices and functions as a liaison between offices at Capital Health.

• Education:
  
  High school diploma or equivalent.
• Experience:
  
  Six months in Patient Access Rep I role at Capital Health or one year customer service experience with medical terminology.
• Knowledge and
  
  Skills:
  
  Excellent communication, interpersonal and organizational skills; ability to problem‑solve, multitask and manage frequent interruption; expert and current knowledge of all aspects of insurance requirements.
• Special Training:
  Proficient computer skills; familiar with medical terminology; knowledge of insurance plans and insurance experience preferred.
• Mental, Behavioral and Emotional Abilities:
  Ability to work independently and as a team; maintains composure in high‑pressure or fast‑paced environment.

• Identify participating CH insurance plans and non‑participating plans.
• Demonstrate service excellence by professionally assisting patients and customers with utmost respect in a friendly, caring manner.
• Register patients quickly and accurately, exceeding productive levels of a Patient Access Rep I.
• Collect and enter accurate patient demographics, physician information, insurance information, and valid registration‑specific codes; obtain all necessary signatures.
• Verify insurance information, obtain authorizations if not done prior to service; scan essential registration forms into EMR and perform chart follow‑up.
• Perform all job duties independently with minimal supervision.
• Follow payor requirements and identify needs for referrals and precertification; verify benefits on all patient encounters; review chart for accuracy.
• Use computer system, internet‑based insurance applications, and departmental operational procedures to obtain accurate demographic, diagnosis, authorizations/referrals, and insurance information.
• Collaborate with other departments, physicians, and physician office staff to obtain essential registration information such as insurance authorizations, referrals, diagnoses, and scripts to secure financial reimbursement and customer/patient satisfaction.
• Comply with department procedures and regulatory guidelines for Medicare Secondary Payer, Medicare Medical Necessity Regulations,…