Patient Services Rep

Job Title: Patient Services Rep

Location: Barnabas Health Medical Group

Department Name: Neurology at the ACC

Req #: 0000237488

Status: Hourly

Shift: Day

Pay Range: $20.60 - $25.84 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 Overview:
The Patient Service Representative Prior Authorization Focus is responsible for managing and coordinating insurance prior authorizations to ensure timely approval of medical services, procedures, imaging, and medications. This role works closely with providers, clinical staff, and insurance companies to prevent delays in patient care and ensure compliance with payer requirements.

Qualifications:

Required:

• High School Diploma or General Education Degree (GED)
• Relevant experience and/or training, or equivalent combination of education and experience
• Demonstrates a clear understanding of the importance of patient satisfaction and safety
• Strong oral and written communications skills
• Attention to accuracy and detail
• Able to multitask and work under pressure
• Ability to work independently and in a team environment

Preferred:

• Associates Degree or Bachelor's Degree
• Previous medical receptionist experience or background in general office
• Knowledge of medical terminology and electronic medical record (EMR) systems

Scheduling Requirements:

• Shift Working: Monday-Friday, 8:30AM-5:00PM
• Day Shift
• Full-Time, 40 Hours Per Week

Essential Functions:

• Initiate, submit, and track prior authorization requests for procedures, diagnostic testing, referrals, and medications
• Review provider orders and clinical documentation to ensure completeness and accuracy prior to submission
• Communicate with insurance carriers to obtain authorization approvals, denials, or requests for additional information
• Follow up on pending authorizations to ensure timely resolution and prevent delays in patient care
• Document authorization status, reference numbers, and outcomes accurately in the electronic medical record (EMR)
• Notify providers and clinical staff of authorization determinations and any required next steps
• Assist with peer-to-peer review coordination when required by insurance plans
• Identify authorization trends, delays, or denials and escalate issues appropriately
• Secondary Responsibilities:
• Verify insurance eligibility and benefits related to prior authorization requirements
• Educate patients on authorization status, expected timelines, and insurance requirements as needed
• Coordinate scheduling of services once authorization approval is obtained
• Maintain organized records of authorization requests and supporting documentation
• Collaborate with front desk, clinical staff, and billing teams to ensure continuity of care
• Required Skills & Competencies:
• Strong knowledge of insurance plans, prior authorization processes, and payer guidelines
• Excellent attention to detail and organizational skills
• Ability to manage multiple authorization requests simultaneously
• Strong communication skills, both written and verbal
• Proficiency with EMR systems and insurance portals
• Ability to work independently while maintaining collaboration with the care team

Other Duties:
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

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.