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 thanĀ 600 physicians and other providersĀ 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.Ā As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.
The listed pay range or pay rate reflects compensationĀ for aĀ full-time equivalent (1.0 FTE)Ā position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).
Pay Range:
$18.57 - $23.23Scheduled Weekly Hours:
40Position Overview
Capital Health Job Descriptions VERSION: 1 JOB TITLE: Rehab Services Access Representative COST CENTER: 000000 JOB CODE: 50245 FLSA Exemption Status: Non-Exempt Telecommuting Eligible: SUMMARY (Basic Purpose of the Job) Assesses insurance requirements for all new and established outpatients as it relates to their specified therapies. Works with clinicians and outpatients to provide an understanding of insurance requirements, evaluates patient insurance benefits, and obtains authorizations in a timely manner. Educates patients in their specific insurance benefits and limitations. Assists patients in navigation of insurance plan, including use of insurance helper tools to ensure patients are aware of deductibles, co-pay amounts, co-insurance amounts, diagnostic exclusions, allowable visits, and need for authorization for therapies. Maintains meticulous documentation and tracking of all communications with insurance companies and works closely with Patient Access and Patient Accounts departments to maximize successful practices and reimbursements. Answers patients and families questions regarding their insurance and provides estimates of co-pay amounts. Facilitates interdisciplinary communication in a timely manner and serves as a resource to all Rehabilitation disciplines. Functions as a super user to ensure department compliance with system and operational changes and assists in training to support ongoing staff education and development. MINIMUM REQUIREMENTS Education: High School diploma or equivalent. Experience: Previous experience in healthcare required. Previous Medical Secretary, Unit Secretary, or Rehab Assistant/Aide experience preferred. Health Access experience in assessing and interpreting patientsā insurance coverage, pre-authorization and insurance procedures preferred. Other Credentials: Knowledge and Skills: Strong organizational skills and ability to create organizational systems. Excellent verbal and written communication skills. Knowledge of medical terminology. Strong knowledge of Medicare health plans, Medicaid guidelines, insurance plans and co-pay assistance programs, and charitable programs. Ability to assess and interpret a patient's insurance benefits. interpret a patient's insurance benefits. Special Training: Mental, Behavioral and Emotional Abilities: Ability to work independently and be self motivated. Usual Work Day: 8 Hours Reporting Relationships Does this position formally supervise employees? No ESSENTIAL FUNCTIONS Assists director and manager in determining and tabulating reimbursement for groups of patients who have been part of a new or special therapy program. Assists with follow up as needed on issues that arise. Assists the patient, family and/or caregiver in understanding of their insurance coverage specific to therapy services. Provides education for patients families regarding the need to understand deductibles, co-pay amounts, co-insurance amounts, diagnostic. Assists with training and education of outpatient therapist staff. Functions as an outpatient rehabilitation super-user, insurance lead, and resource to staff. Educates new clerical staff in proper procedures to ensure insurance coverage. Establishes and maintains systems for verification and monitoring of individual patient insurance coverage, number of authorized visits for therapy, etc. Interacts with insurance companies to determine coverage, as an advocate for the patient. Meets regularly with director and manager to discuss insurance issues and analyzes reimbursement and denials. Monitors trends associated with insurance carrier payer requirements for authorization, referrals, coordination of benefits forms and in network verification. Participates and supports department performance improvement initiatives and assists with accurate data collection in support of quality performance improvement. Participates in data collection and in-depth analysis of insurance reimbursement and denials to improve processes, develops preventive plans, and educates others. Reviews the integrity of the outpatient medical record. Audits the electronic medical record for accuracy of secretarial entries, scans, and other chart elements. Seeks out and communicates with members of Patient Access and Patient Accounts to ensure accurate registration, and to increase and share knowledge. Works closely with Rehabilitation Manager and Director to standardize documentation and tracking of all communications with insurance companies. Works in conjunction with each patientās therapist to ensure authorizations for each planned visit. Works to reverse individual patient insurance payment denials when possible, including analysis of cause, submission of requests for retroactive authorizations as needed, etc. Performs all other functions of Rehabilitations Services secretary. PHYSICAL DEMANDS AND WORK ENVIRONMENT Frequent physical demands include: Reaching forward Occasional physical demands include: Standing , Walking , Carry objects , Push/Pull , Twisting , Bending , Reaching overhead , Squat/kneel/crawl Continuous physical demands include: Sitting , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion , Talk or Hear Lifting Floor to Waist 15 lbs. Lifting Waist Level and Above 10 lbs. Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Color Discrimination, Accurate Depth Perception, Accurate Hearing Anticipated Occupational Exposure Risks Include the following: Airborne Communicable Disease , Extreme Noise Levels , Dust/Particulate Matter
This position is eligible for the following 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 ā Long Term Disability (LTD)
Disability Benefits ā 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.Ā
The salary applies specifically to the position being advertised and does not include po
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