Patient Access Representative II - FT - Day - Patient Access Services Pennington NJ

3M HEALTHCARE; Pennington (NJ); On-site; USD 39,000 - 48,000; Full time

Benefits offered by this job

Medical Plan

Prescription drug coverage & In-House

Dental Plan

Vision Plan

Flexible Spending Account (FSA)

Retirement Savings and Investment Plan

Paid Time‑Off Program

Job summary

Capital Health is seeking a Patient Access Rep I to register patients accurately and independently, ensuring database integrity. The role maintains front-end registration finances and insurance verification while upholding excellent customer service.

You will verify insurance, obtain authorizations, and enter precise demographics into the EMR. Strong communication and knowledge of insurance requirements are essential.

Qualifications

• Education: High school diploma or equivalent.
• Experience in Patient Access or medical office settings.
• Strong interpersonal and organizational skills; knowledge of insurance requirements.

Responsibilities

• Register patients accurately and efficiently to ensure data integrity.
• Verify insurance information and determine pre-certifications as needed.
• Input demographics, physician and insurance data; obtain signatures.
• Assist with authorization requests and documentation in the EMR.
• Collaborate with departments to obtain essential registration details.
• Adhere to Medicare/Payor guidelines and communicate professionally.

Skills

Communication skills

Medical terminology

Customer service

Problem solving

Education

High school diploma or equivalent

Job description

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).

Position Overview

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.

Minimum Requirements

• 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.

Essential Functions

• 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, collection of co‑pay, Advance Beneficiary Notice, Advance Directives and Patient's Rights.
• Ascertain and record appropriately the difference between primary care physician, referring physician, and attending physician.
• Utilize Insurance Card Database and/or Insurance Verification guidelines; follow Financial Screening and Self Pay Procedure for Medicaid and Charity Care referrals.
• Assist and support staff departmental training; attend all mandatory department meetings.
• Support and participate in department performance improvement initiatives.
• Perform other duties as needed.

Physical Demands and Work Environment

Frequent physical demands: sitting, standing, walking, wrist position deviation, pinching/fine motor activities, keyboard use/repetitive motion.
Occasional physical demands: climbing (e.g., stairs or ladders), carrying objects, pushing/pulling, twisting, bending, reaching forward, reaching overhead, squatting/kneeling/crawling.
Continuous physical demands: talk or hear; lifting floor to waist 15 lbs; lifting waist level and above 10 lbs.

Sensory requirements: accurate near vision, accurate far vision, accurate depth perception, accurate hearing.
Anticipated occupational exposure risks: bloodborne pathogens, airborne communicable disease, extreme noise levels, dust/particulate matter.

Benefits

• Medical Plan
• Prescription drug coverage & In‑House Employee Pharmacy
• Dental Plan
• Vision Plan
• Flexible Spending Account (FSA)
  • Healthcare FSA
  • Dependent Care FSA
• Retirement Savings and Investment Plan
• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
• Disability Benefits – Long Term Disability (LTD)
• Disability Benefits – Short Term Disability (STD)
• Employee Assistance Program
• Commuter Transit
• Commuter Parking
• Supplemental Life Insurance
  • Voluntary Life Spouse
  • Voluntary Life Employee
  • Voluntary Life Child
• Voluntary Legal Services
• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
• Voluntary Identity Theft Insurance
• Voluntary Pet Insurance
• Paid Time‑Off Program

The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level. The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.