Customer Service Representative RWJBarnabas Health Somerset

Title Customer Service Representative
Date 2020
Company RWJBarnabas Health
City Somerset

Short Description :

Service telephone number This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines However, some filing is required Inform the clinical area|patient care coordinators ,…

Full Description :

Children s Specialized Hospital is the nation s leading provider of inpatient and outpatient care for children from birth to 21 years of age facing special health challenges from chronic illnesses and complex physical disabilities like brain and spinal cord injuries, to developmental and behavioral issues like autism and mental health.

Children's Specialized Hospital is now in its third century of caring for those in need. Our Boards of Trustees, physicians, therapists, nurses, staff, volunteers, and donors remain dedicated to the very ideals of the Hospital's founders and committed to providing the best care possible so that every child who seeks our help reaches their fullest potential.


At 16 different New Jersey locations, our pediatric specialists partner with families to make our many innovative therapies and medical treatments more personalized and effective...so children can achieve more of their goals.

Job Summary

Responsible for providing exemplary customer service while interacting with internal and external customers. Completes pre-determination of benefits and financial clearance for new and recurring patients. Contacts insurance companies to verify patient s eligibility and benefits, as well as discuss additional financial resources to maintain the patient continuum of care. Communicates with Clinicians, Team Leads, Supervisor of IV&A and Manager of Payer Services IV&A. Verifies pre-registration information for patients ensuring that all information is in the hospital information system is accurate and complete. Maintains patient confidentiality at all times.

Essential Job Functions
  • Assist with resolving patient disputes.
  • Initiate call to family regarding insurance plan benefits and out of pocket responsibility.
  • Answer incoming telephone calls to the customer service telephone number.
  • Manage IV&A email correspondence.
  • Assist patients in resolving questions regarding their accounts.
  • Complete a pre-determination for insurance coverage for new and recurring outpatients seeking services at CSH. These service lines include Occupational, Physical, Speech Therapy, Psychology, Chronic Pain Evaluations, Botox and Alcohol Blocks. Inform families of their financial responsibility (if any) and insurance benefits.
  • Notify parents of availability of financial assistance programs, specifically: NJ FamilyCare and CSH Benefit Fund. Distribute application and follow up as necessary.
  • Serve as liaison between Payer, Patient Accounts, Therapist, Clinician, and the Patient s parent|guardian with respect to financial issues.
  • Maintain Authorizations and re-authorizations, notify clinical departments of authorization status and the need for re-authorization when necessary. Notify parents of authorization status as necessary.
  • Maintain an organized financial record for all patients interviewed. Provide detailed notes in the hospital information system as documentation of all contact with payers, and|or parents.
  • Inform the clinical area|patient care coordinators and parents of any denials.
  • Other tasks assigned by management.

Formal Education and Job-Related Experience
  • Some college or equivalent preferred.
  • Minimum of one to five years of hospital financial experience either in Patient Access Services or in Patient Financial Services.
  • Ability to work well individually and in a team environment.
  • Able to work in a professional, corporate setting.
  • Ability to identify trends and issues as related to specific patients or services.
  • Excellent oral and written communication skills.
  • Must be able to do basic calculation to provide family with accurate out of pocket responsibility.
  • Bilingual Candidate Preferred

Education and ExperienceAdditional Comments
  • Flexible, hardworking individual with the ability to manage multiple tasks.
  • Must be self-motivated and work well in a team environment, as well as work independently.
  • Excellent customer services skills. Healthcare| Insurance background preferred.
  • Sound problem solving and communication skills.
  • Ability to professionally interact with people (i.e., parents, staff, patients, Managed Care Organizations, outside agencies, etc.) familiarity with computer software packages (Microsoft OfficeMeditech).
  • Aptitude to organize and follow specific instructions.
  • Maintain patient confidentiality.
  • Knowledge of NJ financial programs (Medicaid, Charity Care).
  • Ability to communicate a financial plan for the patient.

Job Specific Contacts

Constant contact with Hospital staff, parents, patients, managed care organizations and outside agencies.

Physical Demands

This position operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

This is largely a sedentary role; however, some filing is required. This would require the ability to move files, open filing cabinets and bend or stand as necessary.


RWJBarnabas Health is an

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