Scheduler, Healthcare

Overview

POSITION OVERVIEW:

Schedules patient appointments for visits, diagnostic tests, referrals and/or consults, and any surgical procedures. Will be responsible for obtaining referral and/or insurance authorization/pre-certification approvals from health plan or primary care physician office. Documents patient calls via electronic medical record phone notes. Financial responsibilities may include but are not limited to the following: verifying guarantor information and collection of any monies due at the time of service.

Provides efficient flow of clinical information via paper and electronic medical records. Works closely with patients, providers, and hospital facilities.

• Contact insurance carriers to verify patient's insurance eligibility, benefits and requirements.
• Request, track and obtain pre-authorization from insurance carriers within time allotted for medical services.
• Request, follow up and secure prior-authorizations prior to services being performed.
• Schedule patients for surgery, completing appropriate facility paperwork.
• Schedule patients for any required diagnostic tests prior to surgery (for example MRI, CT).
• Review patient medications and health history to determine pre-admission testing.
• Schedule appropriate medical and other clearances.
• Schedule patients for follow-up appointments and tests.
• Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
• Communicate any insurance changes or trends among the team.
• Maintains a level of productivity suitable for the department.
• Clearly document all communications and contacts with providers and personnel in standardized documentation requirements, including proper format.
• Escort patients to rooms, obtain vitals, perform check-in and check-out duties
• Other duties as assigned.

• Education:
  
  High school diploma.
• 2 years surgery scheduling/prior authorization experience required.
• Must have excellent verbal and written communication skills.
• Requires effective customer relation skills, ability to organize and interpret data.
• Requires good judgment, tact, diplomacy, and ability to problem solve.

• Typical business office environment
• Possibility of local travel
• Constant viewing of computer monitor, mousing and typing
• Frequent standing, walking and sitting
• Frequent stooping, lifting, carrying and pushing/pulling 10 pounds or more
• Occasionally lift and/or move up to 50 pounds
• Specific vision abilities required by this job include close vision, color vision, peripheral vision, and ability to adjust focus
• Hours of business are Monday – Friday from 8:00 a.m. to 5:00 p.m. Must be able to work early, late and long hours, as needed, to meet the essential functions of the job