Jacelyn Conwell Financial Counselor at RWJ Barnabas Health

Precertification Rep (Contract)

Ensemble Health Partners

Jan 2025 - Apr 2025 (4 months)

Coordinated verification processes to ensure compliance with payer requirements and support seamless claim submission. Verifies benefits and eligibility for In-Patient and Out-Patient services, scheduled and unscheduled procedures. Assesses patient liability and communicates financial obligations—including deductibles, co-payments, and co-insurance to support proper reimbursement and improve patient understanding of hospital charges.

Financial Counselor

RWJ Barnabas Health

Jul 2017 - Current (8 years 11 months)

Process 40–60 prior authorizations daily across multiple specialties, ensuring medical necessity per payer guidelines. Works in conjunction with Utilization Review nurses to coordinate precertification process; provides documentation and clinical information as necessary to insure proper claim submission, and proper reimbursement for 5 different specialties Coordinated provider credentialing and verification processes to ensure compliance with payer requirements and support seamless claim submission. Reduced average authorization turnaround time from 3 days to 1.5 days, improving patient scheduling efficiency. Verifies benefits and eligibility for In-Patient and Out-Patient services, scheduled and unscheduled procedures. Assesses patient

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Precertification Coordinator (Contract)

Jersey Rehab

Oct 2016 - May 2017 (8 months)

• Coordinated precertification for physical therapy services by verifying insurance requirements, obtaining authorizations, and ensuring compliance with payer guidelines. • Communicated with insurance companies, providers, and patients to secure timely approvals for physical therapy treatments and procedures. • Reviewed medical necessity for therapy services against clinical guidelines to support appropriate care and reimbursement.

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Managed Care Coordinator (Temp)

Horizon Blue Cross Blue Shield of NJ

Oct 2015 - Sep 2016 (1 year)

• Resolved managed care issues, including authorizations, billing, and claims. • Ensured compliance with Medicare, Medicaid, and managed care policies. • Supported member enrollment, inquiries, and claim resolution. • Reviewed and analyzed contract terms, renewals, and obligations. • Prepared cost estimates to support financial planning.

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Patient Access Rep

East Orange General Hospital

Jun 2010 - Dec 2015 (5 years 7 months)

• Verified patient demographics, employment, workers' compensation, and insurance information for accuracy. • Secured insurance precertifications, authorizations, and referrals as required. • Entered and validated ICD-9, ICD-10, and CPT codes in the billing system. • Determined patient financial liability to ensure accurate reimbursement of accounts. • Coordinated utilization reviews and provided financial counseling as needed. • Communicated deductibles, co-payments, and co-insurance details to patients prior to and during hospital visits.

Patient Representative

Ivy Rehab

Mar 2007 - Feb 2009 (2 years)

Verification of all demographic, employment, worker's compensation and insurance information to ensure accuracy. Obtained insurance precertification, referral, and authorizations Submitted insurance claims, processed EOBs and denied claims, Tracks money collected and verifies total against receipt sheet daily.

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Scheduling Secretary (Temp)

Newark Beth Israel Hospital

Apr 2005 - Dec 2006 (1 year 9 months)

• Scheduled and coordinated patient appointments, diagnostic tests, and cardiac procedures to ensure efficient department flow. • Verified patient demographics, insurance eligibility, and referral requirements prior to visits • Obtained prior authorizations and precertifications for cardiac services and procedures. • Managed high-volume phone calls, responding to patient inquiries with professionalism and accuracy. • Maintained physician calendars and coordinated schedules among providers, staff, and patients. • Prepared and distributed daily schedules, ensuring accuracy and timely communication. • Entered and updated patient information in the electronic health record (EHR) system. • Supported front-desk operations, including check-in, che

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Dental Receptionist & Assistant

Yogi Dental Center

Feb 2000 - Feb 2005 (5 years 1 month)

• Scheduled and confirmed patient appointments, procedures, and follow-ups to maintain an efficient office flow. • Verified insurance coverage, processed claims, and collected co-pays and balances at check-in and check-out. • Answered high-volume phone calls and responded to patient inquiries with professionalism and accuracy. • Maintained patient records in the dental software system, ensuring accuracy and confidentiality. • Coordinated communication between patients, dentists, and hygienists to optimize scheduling and care. • Prepared treatment rooms, sterilized instruments, and ensured proper infection control procedures. • Assisted dentists during exams, cleanings, and procedures by handing instruments and providing chairside support. •

Jacelyn Conwell

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