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Attention Previous Applicants – On Thursday, September 14, 2017, Rowan University transitioned to a new hiring system. Previous applicants will need to create a new applicant profile for any new applications.

Rowan University is a Carnegie-classified Doctoral University (Moderate Research Activity) with approximately 17,300 students. Its main campus is located in Glassboro, N.J., 20 miles southeast of Philadelphia, with additional campuses in Camden and Stratford. The University comprises seven academic colleges and five schools—the William G. Rohrer College of Business; the Henry M. Rowan College of Engineering; the Colleges of Communication and Creative Arts, Education, Humanities and Social Sciences, Performing Arts, and Science and Mathematics; the Cooper Medical School of Rowan University; the Rowan University School of Osteopathic Medicine; the Graduate School of Biomedical Sciences; the School of Health Professions; and the School of Earth and Environment—with an Honors College that spans across disciplines. Rowan is one of two public universities in the country to offer M.D. and D.O. medical degree programs. The institution is also home to the South Jersey Technology Park, which fosters the translation of applied research into commercial products and processes. Rowan has been recognized as one of the top 100 public universities in the nation and is ranked third among public institutions in the North by U.S. News & World Report.

Rowan University is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, creed, color, national origin, age, ancestry, nationality, marital or domestic partnership or civil union status, sex, pregnancy, gender identity or expression, disability status, liability for military service, protected veteran status, affectional or sexual orientation, atypical cellular or blood trait, genetic information (including the refusal to submit to genetic testing), or any other category protected by law. For the complete Rowan University non-discrimination and affirmative action policy see: https://sites.rowan.edu/equity/_docs/policies/eeo-statement.pdf.

 

Clinical Services Rep II

Apply now Job no: 492861
Work type: Regular full time
Location: Stratford, New Jersey
Categories: Administrative - Clerical

 

SUMMARY:

Under direction of the Director of Administration, is responsible for managing the patient eligibility and verification of insurance coverage prior to delivery of services. Assists Department in working with external partners to communicate participating insurance plans on an ongoing basis and actively monitors changes to provider census list for appropriateness; assists providers in establishing schedule for off-site services.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

Obtains accurate and complete registration for all patients in ambulatory practice and/or facility by communicating with external partners, patients and/or families as necessary to collect demographic and insurance information.

Reviews and documents obtained demographic and insurance information and takes necessary steps to ensure accuracy of such patient information; reviews need for referrals and any other additional documentation; enters when necessary to reduce rejections.

Responsible for independently understanding the details of the fee for service and managed care (primary and secondary) insurance reimbursement requirements. 

Utilizes appropriate tools for finding patient demographic & insurance information such as Centricity IDX, WebMD, NaviNet, etc. If necessary makes follow up calls to patients, external partners and third party payers utilizing effective communication skills to provide customer service where necessary.

Composes letters to patients, external partners and third-party payers when necessary as related to assigned work.

Obtains and/or creates and manages multiple census lists of patients being seen at external partner facilities; updates as necessary and assists providers with ensuring appropriate follow up visits are scheduled regularly.

Responsible for ensuring that all providers are credentialed appropriately and all required licenses are current. Maintains the credentialing and licensing files for all providers; keeps detailed records to ensure files are always current, informs providers of status & follows up with them for action when necessary.  

Performs within specified standards for productivity, accuracy and attendance. Maintains standardized work station and reference manuals to not only promote efficiency but also to promote effective patient/partner relations.

Utilizes compliant processes to protect patient information with highest level of confidentially. 

Responsible for all special projects as assigned by Director of Administration.

Understands and adheres to Rowan compliance standards as they appear in the Corporate Compliance Policy, Code of Conduct and Conflict of Interest Policy.

Keeps abreast of all federal, state and Rowan University regulations, laws and policies as they presently exist and as they change or are modified.

Performs other duties as assigned.

QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE

Three to five (3-5) years of experience in clinical office support operations with in-depth knowledge of physician schedule planning and billing practices for a variety of insurance types. Experience with Centricity IDX & EMR and proficiency in Microsoft Office especially Excel strongly preferred. Must have in-depth knowledge of the verification & eligibility process for all types of insurance/payers. Knowledge of credentialing and licensing process strongly preferred. Experience with Medicare, Medicaid and Medicare Advantage plans required. Experience in handling billing issues specific to the geriatric population and corresponding external providers such as Skilled Nursing Facilities, home visits, hospice, etc. strongly preferred. Ability to create and maintain complex physician work schedules at multiple sites required. Strong investigative skills to locate demographic and insurance information required. Familiarity with CPT & ICD-10 coding guidelines strongly preferred. Must have experience multi-tasking & following up on outstanding assignments in a timely manner while in fast pace environment. Excellent communication skills to interact with many different levels of internal and external partners required.  Must be detail-oriented, organized and professional at all times.  

SALARY GRADE:

WP1775

Min. $18.72

Mid. $19.22

Max. $19.79

 

 

 

Advertised: Eastern Daylight Time
Applications close: Eastern Daylight Time

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Current Opportunities

Position Location Closes
Clinical Services Rep II Stratford, New Jersey

Rowan University is committed to assisting all members of the Rowan community in providing for their own safety and security. The Annual Security and Fire Safety Report is available on the Department of Public Safety website at: https://sites.rowan.edu/publicsafety/_docs/annual_security_report.pdf

If you would like to receive a hard copy of the Annual Security and Fire Safety Report which contains this information, you can stop by the Department of Public Safety Office, located at Bole Hall Annex, 201 Mullica Hill Road, Glassboro, NJ 08028 or you can request that a copy be mailed to you by calling (856) 256-4562 or 4506. The report contains information regarding campus security and personal safety including topics such as: crime prevention, public safety authority, crime reporting policies, fire safety, disciplinary procedures and other matters of importance related to security on campus. The report also contains information about fire statistics in Rowan University Residential Facilities and crime statistics for the three previous calendar years concerning reported crimes that occurred on campus; in certain off-campus buildings or property owned or controlled by the University; and on public property within, or immediately adjacent to and accessible from the campus. This information is required by federal law, Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act or "Clery Act" and is provided by the Rowan University Department of Public Safety.

All positions are contingent upon budget appropriations.