| 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 six centers and institutes that focus on cancer treatment and research, neuroscience, clinical and translational research, 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 including New Brunswick, Piscataway, Newark, Scotch Plains, Somerset, Blackwood, and other locations. Clinical partners include Robert Wood Johnson University Hospital in New Brunswick, 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 Surgical Representative for the Medicine Clinic at the Robert Wood Johnson Medical School.
Serves as primary staff liaison with all surgery patients from initial physician recommendation for surgery until surgery is completed. Provides financial planning and service to patient and physicians to facilitate the scheduling and performance of surgical procedures; provides support paperwork and documentation to patients and physicians; maintains awareness of various HMO’s, Commercial PPO’s, Medicare, Medicaid HMO’s, workers comp/no fault insurance carriers restrictions to assure all necessary criteria are met prior to surgery.
Among the key duties of this position are the following: - Serves as a liaison for the OMFS interns, residents, and fellows by providing insurance guidelines, authorizations, and support for clinic patients requiring surgery.
- Reviews surgical procedures with doctor to make CPT and ICD coding recommendations.
- Verifies patient eligibility and benefits, and obtain pre-authorization, if required, for surgery.
- Utilizes HCPCs codes to secure authorization for nutritional supplements, medications, or other items, deemed medically necessary, for an effective recovery for the patient.
- Effectively communicates with patient registration desk, utilization management, nurses and medical director to give all pertinent clinical documentation as required to secure the surgical authorization.
- Tracks status of pending pre-certifications and pre-authorizations, keeping the providers informed of status. Maintains and updates notes on the Authorization Status Report for all team members to access information, as needed.
- Informs prospective surgery patients of insurance coverage and their financial responsibility. Utilizes surgical authorization form for patient to sign reflecting insurance benefits, patient responsibility, and establishing payment plans as necessary.
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