Clinical Services Representative I
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About The Position
Rutgers, the State University of New Jersey, is seeking a Clinical Services Representative I for the Neurosurgery Department within Robert Wood Johnson Medical School. The RWJMS Clinical Services Representative I performs administrative tasks as assigned to support effective and efficient office operations. This includes managing incoming requests for third party carrier prior authorizations for testing, procedures, medications, and DME. The representative reviews requests for compliance, accuracy, and completion, and initiates requests using online websites, portals, and telephone in a time-sensitive manner. Comprehensive documentation and relaying resolution of prior authorization requests to the department providers, external providers and entities, and patients as appropriate is also required. The role involves providing appeal or peer-to-peer contact information when necessary and is responsible for timely re-work of pending requests for approval and/or providing any required additional information from the EMR in order to obtain an approval. Additionally, the representative provides patient check-in, insurance verification, and collects payment, ensuring timely completion of work queue tasks.
