Patient Access Specialist

RWJBarnabas Health; Somerville (NJ); On-site; USD 30,000 - 37,000; Full time

Job summary

RWJBarnabas Health in New Jersey is seeking a Patient Access Specialist to help secure financial clearance before, during, and after service. The role supports throughput, collaborates with clinical teams, and analyzes revenue impact to drive process improvements.

A strong customer service mindset and knowledge of prior authorization workflows are essential. The position is full-time, daytime hours, at RWJ Somerset, with responsibilities spanning data review, escalation, and cross-department

Qualifications

• High school diploma or equivalent required.
• Minimum of 2 years of Patient Access Representative experience.
• Experience with prior authorization processes and payer portals is preferred.

Responsibilities

• Identify data sets for review and work queues to ensure financial clearance.
• Manage volume and scheduling to analyze clearance risk.
• Coordinate follow-up with leadership, departments, and clinical teams to pursue unsecured volume.
• Escalate at-risk cases for validation of delay/deferral options based on clinical condition.
• Analyze denials/rejections to identify root causes and suggest process improvements.
• Audit end-user activities and participate in re-education opportunities.
• Collaborate with patient access, corporate, and clinical departments for workflow review.
• Provide leadership with summaries of findings for action planning.

Skills

Customer service

Prior authorization knowledge

Data & reporting

Education

High school diploma or equivalent

Tools

Microsoft Excel

Real Time Authorization

Job description

Patient Access Specialist

Facility: RWJ Somerset

Department: Patient Access Services

Location: RWJUH Somerset

Status: Full-Time

Shift: Day

Pay Range: $21.72 - $27.00 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.

The Patient Access Specialist position plays a key role in Patient Access by ensuring all steps are taken to financially secure accounts prior to, during service or post service. This role utilizes applicable knowledge, skills, and abilities in reviewing and analyzing volume and data to identify issues and opportunities to make recommendations for changes that support process improvement; act as a liaison for streamlined throughput; and collaborate with clinical/departmental counterparts to ensure financial, safety and patient experience goals are met

As a Patient Access Specialist, a typical day might include:

• Identify appropriate data set for review/assignment (i,e, filtering dashboards, reports, and work queues)
• Volume/schedule management to analyze financial clearance risk
• Coordinate follow up with local patient access leadership, clearance team, clinical departments, etc, to pursue follow-up of unsecured volume for review and escalation for resolution
• Once financial clearance status has been determined as unsecured, will escal at-risk volume clinical/departmental counterparts so they can validate delay/deferral options based on the patient s clinical condition
• Will analyze financial outcomes (i,e, denials and rejections data) to identify themes in root cause and make recommendations for process, technology, or assignment changes that will prevent future revenue risk
• Audits end user activities to provide in-depth quality analysis and participate in communication for re-education opportunities
• Works work queues and other reports for resolution of accounts,
• Escalates trending errors to management for resolution or training
• Works with patient access, corporate and clinical department for workflow review and potential education
• Provides summary of findings to leadership as part of overall action planning
• Participate in training through the development of training tools, presentations at department in-services or staff meetings, or through the training of registration staff outside of the patient access department
• May perform other duties as assigned or directed by management
• Knowledge, Skills, & Abilities (list no more than 12):
• Meets individual targets including accuracy and productivity
• Provides excellent customer service to all patients, colleagues and other external and internal customers
• Strong understanding of prior authorization requirements for various services
• Experience in authorization submission workflow and related technology (Real Time Authorization, Payer portals, TPA authorization forms,

• Comfortable communicating with patients, providers, and insurance companies to initiate, update and append authorization to support financial outcomes
• Demonstrates proficiency in the entire pre-admission, registration, and financial clearance process
• Ability to proactively identify and resolve in decision-making,
• Proficiency in reporting systems to filter, edit criteria, sort, pivot, and extract data,
• Reflects commitment to building a supportive work environment and maintains a positive attitude
• Works closely and professionally with all team members to foster a collaborative team environment,

This role might be for you if:

• You thrive in a fast-paced environment.
• You are good at multitasking and customer service.
• You have experience working within healthcare or other related areas which are customer service focused.

To be considered for this opportunity, you must have the following qualifications:

Required:

• High school diploma or equivalent required
• Minimum of 2 years of Patient Access Representative Experience

Preferred:

• Customer service experience
• Medical terminology experience
• Microsoft Excel

Why You'll Love Working Here:

At RWJBarnabas Health, our people are at the center of everything we do. Through our Total Wellbeing promise, we offer a wide range of benefits and resources to support your physical, emotional, financial, and professional wellbeing. Highlights include:

• Paid Time Off (PTO)
• Medical and Prescription Drug Insurance
• Dental and Vision Insurance
• Retirement Plans
• Short & Long Term Disability
• Life & Accidental Death Insurance
• Tuition Reimbursement
• Health Care/Dependent Care Flexible Spending Accounts
• Wellness Programs
• Voluntary Benefits (e.g., Pet Insurance)
• Discounts Through our Partners such as NJ Devils, NJ PAC, Verizon, and more!

RWJBarnabas Health is an Equal Opportunity Employer