Position Details
Position Information
| Recruitment/Posting Title |
Clinical Services Representative I |
| Job Category |
Staff & Executive - Administrative & Support |
| Department |
RWJ-Neurosurgery-Meb |
| Overview |
New Jersey's academic health center, Rutgers Biomedical and Health Sciences (
RBHS) takes an integrated approach to educating students, providing clinical care, and conducting research, all with the goal of improving human health. Aligned with Rutgers University-New Brunswick and collaborating university wide,
RBHS includes eight schools, a behavioral health network, and five centers and institutes that focus on cancer treatment and research, neuroscience, advanced biotechnology and medicine, environmental and occupational health, and health care policy and aging research.
Our faculty are teachers, clinicians, and scientists with unparalleled experience who advance medical innovation and provide patient care informed by the latest research findings. We offer an outstanding education in medicine, dentistry, pharmacy, public health, nursing, biomedical research, and the full spectrum of allied health careers.
Our clinical and academic facilities are located throughout the state-at Rutgers University-New Brunswick, including Piscataway; and at locations in Newark, Scotch Plains, Somerset, Stratford, and other locations. Clinical partners include Robert Wood Johnson University Hospital in New Brunswick, Newark's University Hospital in Newark, and other affiliates.
Through this community of healers, scientists, and scholars, Rutgers is equipped as never before to transform lives. |
| Posting Summary |
Rutgers, The State University of New Jersey, is seeking a Clinical Services Representative I for the department of Neurosurgery at the Robert Wood Johnson Medical School.
The
RWJMS Clinical Services Representative I; performs administrative tasks as assigned to support effective and efficient office operations. Manages incoming requests for third party carrier prior authorizations for testing, procedures, medications and
DME. Reviews request for compliance, accuracy and completion and initiate 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. Providing appeal or peer-to-peer contact information when necessary. 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. Provide patient check-in, insurance verification and collect payment. Timely completes work queue tasks.
Among the key duties of this position are the following:
- Manage requests from physicians, clinical staff, hospitals, community providers and pharmacies using exemplary customer service skills.
- Review the patient's EMR for accurate and complete data needed to initiate a request for Prior Authorization of Notification of Services. Request any additional information needed to obtain Prior Authorization. Use provided tools (at -a- glance notes, User Tables, etc.) to access the need to proceed with a Prior Authorization request based on the patient's insurance.
- Review structured clinical data in the EMR to match against specific medical terms, diagnoses and procedure codes (without need for interpretation) and follow established process for authorization request or referral for additional required information prior to submission for Prior Authorization request.
- Accurately provide required information from the EMR to third party carrier, clinical and lay-person representatives using the appropriate modality of internet portals, websites, and call centers to begin the Prior Authorization process as outlined and defined by the insurance carrier/third party vendor. Verify the eligibility of the patient's health insurance.
- Competently performs the following financial functions based on assignment: Scheduling, pre-registration, recording patient arrival, administering financial and HIPAA paperwork, obtaining necessary signatures, receiving referral and pre- certification numbers; performs online insurance verification to assist patient with their payment options.
|
| FLSA |
Nonexempt |
| Grade |
185 |
| Salary Details |
A maximum of $27.18 per hour is budgeted for this position |
| Minimum Salary |
26.680 |
| Mid Range Salary |
27.180 |
| Maximum Salary |
28.000 |
| Offer Information |
The final salary offer may be determined by several factors, including, but not limited to, the candidate's qualifications, experience, and expertise, and availability of department or grant funds to support the position. We also take into consideration market benchmarks, if and when appropriate, and internal equity to ensure fair compensation relative to the university's broader compensation structure. We are committed to offering competitive and flexible compensation packages to attract and retain top talent. |
| Benefits |
Rutgers offers a comprehensive benefits package to eligible employees, based on position, which includes:
- Medical, prescription drug, and dental coverage
- Paid vacation, holidays, and various leave programs
- Competitive retirement benefits, including defined contribution plans and voluntary tax-deferred savings options
- Employee and dependent educational benefits
- Life insurance coverage
- Employee discounts programs
For detailed information on benefits and eligibility, please visit:
http://uhr.rutgers.edu/benefits/benefits-overview. |
| Position Status |
Full Time |
| Working Hours (per week) |
40 |
| Standard Hours |
40.00 |
| Daily Work Shift |
Day |
| Work Arrangement |
This position requires a fully on-site work arrangement. |
| Union Description |
Teamsters 97 |
| Payroll Designation |
PeopleSoft |
| Seniority Unit |
|
| Terms of Appointment |
Staff - 12 month |
| Position Pension Eligibility |
PERS |
Qualifications
| Minimum Education and Experience |
- Three(3) years of progressively responsible clerical experience required of which at least one (1) year must have been in a medical billing setting, including management of various types of insurance billing processes and Pre-authorizations.
- Experience in accessing and retrieving information from a computer database is required.
|
| Certifications/Licenses |
|
| Required Knowledge, Skills, and Abilities |
- Familiarity with medical terminology required.
- Superior customer service is required.
- Excellent communication and organization skills and a demonstrated ability to work independently are required.
|
| Preferred Qualifications |
- Knowledge of medical services coding.
|
| Equipment Utilized |
|
| Physical Demands and Work Environment |
- Physical Demands: Standing, sitting, walking, talking and hearing .No special vision requirements. Must be able to lift or exert force up to ten (10) pounds.
- Work Environment: Moderate noise environment with some exposure (less than 1/3 of the time) to bloodborne pathogens requiring the use of personal protective equipment; some potential exposure(less than 1/3 of the time)to hazardous waste.
|
| Special Conditions |
|
Posting Details
| Posting Number |
25ST1400 |
| Posting Open Date |
|
| Special Instructions to Applicants |
|
| Regional Campus |
Rutgers Biomedical and Health Sciences (RBHS) |
| Home Location Campus |
Downtown New Brunswick |
| City |
New Brunswick |
| State |
NJ |
| Location Details |
|
Pre-employment Screenings
All offers of employment are contingent upon successful completion of all pre-employment screenings. Immunization Requirements
Under Policy 100.3.1 Immunization Policy for Covered Individuals, if employment will commence during Flu Season, Rutgers University may require certain prospective employees to provide proof that they are vaccinated against Seasonal Influenza for the current Flu Season, unless the University has granted the individual a medical or religious exemption. Additional infection control and safety policies may apply. Prospective employees should speak with their hiring manager to determine which policies apply to the role or position for which they are applying. Failure to provide proof of vaccination for any required vaccines or obtain a medical or religious exemption from the University will result in rescission of a candidate's offer of employment or disciplinary action up to and including termination. Affirmative Action/Equal Employment Opportunity Statement
It is university policy to provide equal employment opportunity to all its employees and applicants for employment regardless of their 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. As an institution, we value diversity of background and opinion, and prohibit discrimination or harassment on the basis of any legally protected class in the areas of hiring, recruitment, promotion, transfer, demotion, training, compensation, pay, fringe benefits, layoff, termination or any other terms and conditions of employment. For additional information please see the Non-Discrimination Statement at the following web address: http://uhr.rutgers.edu/non-discrimination-statement |
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Jun 26, 2025