Per Diem Scheduler Authorization Representative (Outpatient Infusion Clinic)

Position Summary

Serves as the primary point of contact for patient scheduling, registration, and ensuring timely authorization form insurance carriers to optimize the hospital's revenue cash flow. Coordinating schedules for patients and providers. Collects, verifies and updates patient demographic and guarantor information. Verifies insurance benefits/eligibility, manages referrals runs patient estimate, collects copays and patient estimated out of pocket expenses and appropriate. Performs appointment scheduling, registration and customer services duties. Obtains authorization and re-authorization as needed, for both professional and facility services as well as notification for inpatient stays.

Job Requirement

• Education/Experience: Equivalent to graduation from high school and two (2) years Admitting Discharge experience in a hospital setting or one (1) year surgery scheduling experience or one (1) year experience working in a physicians office performing scheduling/authorization activities.
• Additional Position Requirements: Notice of Admission experience. Minimum of two (2) years of experience in submitting authorizations. Must have Epic experience. Insurance verification experience of 1 year or more. Direct Admission experience. Available to work weekdays and weekends.

Knowledge Of

• Scheduling and authorization procedures;
• Medical terminology;
• Laws, rules, and regulations governing area of assignment;
• Financial system and insurance requirements;
• Commercial and governmental payers, Medicare plans;
• CPT, ICD 10 procedure coding;
• Medicare rules and regulations;
• Department and hospital safety practice and procedures;
• Patient rights;
• Age specific patient care practices;
• Infection control policies and practices;
• Handling, storage, use and disposal of hazardous materials;
• Department and hospital emergency response policies and procedures.

Skills

• Communicating effectively with physicians, patients, and other employees;
• Customer services;
• Computerized scheduling system;
• Verifying benefits and eligibility;
• Forms and applications according to laws and guidelines in area of assignment;
• Preparing technical and statistical reports;
• Performing technical, specialized office support work;
• Using initiative and judgement within established procedural guidelines;
• Setting priorities and meeting critical deadlines;
• Using computers and related software applications;
• Communicating with a wide variety of people from diverse socio-economic and ethnic backgrounds;
• Establishing and maintaining effective working relationships with all personnel contacted in the course of duties;
• Efficient, effective and safe use of equipment.

Physical Requirements And Working Conditions

• Mobile to work in a typical clinical setting and use standard office equipment;
• Stamina to remain seated for extended periods of time and maintain concentration;
• Vision to read printed materials and a VDT screen;
• Hearing and speech to communicate effectively in person and over the telephone.

Strength And Agility

• Strength and agility to exert up to 10 pounds of force occasionally and/or an eligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body.