Preauthorization Associate

Job Title : Associate Location : Morris Cancer Center Department Name : Cancer Ctr-Admin Req : 0000212050 Status : Hourly Shift : Day Pay Range : $17.17 - $25.00 per hour Pay Transparency : The above reflects the anticipated hourly wage range for this position if hired to work in New Jersey. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience. Job Function : The Program Associate is responsible for serving as a liaison for patients with respect to financial and scheduling issues. The Program Associate will work collaboratively with all research and non-research staff to maintain a timely and organized flow of patients through the clinical research process scheduling and insurance procedures. This role will focus on research patients, assuring that the patient experience of the research subject is positive and progresses smoothly. Education : Bachelor's degree in business- or health-related field required Experience : Minimum of one year of experience in a medical office setting physician office, hospital, clinic, health insurance company required Knowledge of medical insurance benefit coverage assessment and processing required Knowledge of oncology medical terminology, Medicare, Medicaid, managed care, traditional insurance, CPT, ICD-10 coding, and computerized billingsystems required Bilingual in Spanish strongly preferred Work Environment and Hazards Healthcare office environment Special Physical Demands Physical Demands Position entails frequent standing, bending, lifting and walking A physical condition that allows reaching and general mobility within the departments Manual dexterity is required Visual acuity must be such as to enable accurate performance of essential job duties Hearing and speech must permitdirect and telephone communication In addition, must be able to function under rapidly changing and stressful conditions Sitting, standing, walking,some bending and lifting Other Physical Demands as required Work Contact Group / Additional Responsibilities Interrelationships with patients, staff, vendors, visitors, physicians Job Specific Requirements Maintains timely and organized flow of patients through the clinical research process as it relates to insurance and billing procedures : Coordinates outpatient procedures for patients enrolled to clinical research studies Meets with all patients at the time of signing consent toensure all insurance information is gathered and a determination is made regarding their benefit eligibility and out-of-pocket expenses Conductsfirst patient study visits to determine charge integrity and distribution is accurate Assists patients in facilitating the processing of applications for Medicare, charity care, and / or specialty pharmacy benefits Collaborates with Chamberlin Edmonds & Associates representatives to investigate the self-pay population and to offer assistance with SSI, SSD, and Medicaid programs Assists the provider with completing all requisitions and paperwork Maintains a log of patients referred for evaluation and financial clearance in appropriate systems Performs various front office procedures : Schedules patient appointments, including outside physician, hospital, and ancillary services Identifies and resolves registration discrepancies Coordinates with the finance department to assign 499 accounts and NCT numbers for appropriate charge capture Coordinates the provision of home care services Obtains authorizations and places orders Ensures appropriate paperwork is submitted to Patient Admitting for research procedures and billing labels are available for patient visit Files all appropriate correspondence andpatient-related information Prepares and handles incoming and outgoing mail Coordinates the receipt of patient medical records Coordinatesthe admission of research patients and ensures proper billing Verifies patient insurance benefits and obtains authorizations as needed for services to be provided Maintains and locates approved insurance carrier list for each physician and practice Obtains authorizations for outpatient treatment and diagnostic studies Obtains gap exceptions for patients with non-participating insurance Assists with research billing procedures and forms as directed Coordinates charge capture and billing issues as it relates to research procedures Reviews billing plans with patients prior to enrollment Queries research team to clarify, reconcile, and complete charge issues Resolves billing questions and queries using internal billing and patient systems Works closely with investigator and research teams to resolve patient billing errors and other study-related charges Ensures clinical research processes are patient centered Actively contributes to creating a friendly, welcoming, and safe environment Treats patients and visitors in a caring and professional manner Drives collaboration with clinical staff, including physicians Continuously displays role-model behaviors to contribute to the company's core values Maintains professional composure and confidence during stressful situations Completes all delegated tasks including, but not limited to orienting and training new team members, attending training programs, modules, workshops, etc. as appropriate, and working collaboratively with all team members to ensure that services are coordinated and delivered to patients Benefits and Perks : At RWJBarnabas Health, our employees are at the heart of everything we do. Driven by our Total Wellbeing promise, our market-competitive offerings include comprehensive benefits and resources to support our employees' physical, emotional, financial, personal, career, and community wellbeing. These benefits and resources include, but are not limited to : Paid Time Off including Vacation, Holidays, and Sick Time Retirement Plans Medical and Prescription Drug Insurance Dental and Vision Insurance Disability and Life Insurance Paid Parental Leave Tuition Reimbursement Student Loan Planning Support Flexible Spending Accounts Wellness Programs Voluntary Benefits (e.g., Pet Insurance) Community and Volunteer Opportunities Discounts Through our Partners such as NJ Devils, NJ PAC, and 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. Equal Opportunity Employer LI-SK1