Job Summary: Scheduling Representative is responsible for accurate coordination and implementation of procedure scheduling for various providers and hospital locations (ie. Endoscopy, OR, St. Mary's). Activities include coordinating all aspects in the preparation for the patient's procedural experience including scheduling the procedure, and pre-admission testing, pre-registration, medical necessity checking, ensuring the presence of complete physician orders, insurance verification, gathering pre-authorizations and pre-certifications, and obtaining and reviewing procedure preparation instructions with patient. Maintains records and produces statistical reports as required, coordinate's distribution of educational materials to patients and families if needed in assigned department. Scheduling requests are presented by multiple providers at once, which require completing multiple tasks simultaneously.
Essential Functions: Receives physician orders and seeks clarification, if necessary; Verifies insurance, obtains pre-authorizations and per-certifications to include medical necessity checking; Answers all telephone inquiries related to scheduling; Schedules patients for procedures/treatments or diagnostic procedures using computerized scheduling systems; When scheduling, implements complex decision matrices involving factors such as block time allotments, equipment requirements and availability, physician's physical ability and stamina, and patient's need/acuity/preference – all with the goal of maximum productivity and efficiency of all resources. Resolves scheduling conflicts, as needed. Documents all information regarding patient re-schedules; Enters patient information in computerized scheduling system and gathers information and modifies records, as needed to maintain current database and manages files within regulatory requirements. Compiles and reports statistical data, if needed by the assigned department. Responds to diverse questions or refers to appropriate clinical staff. Ensures exceptional customer service to Patients, Dept Staff and Management, Visitors, Provider Offices, and all Departments. Orients new staff members to the position as needed.
Requirements: High School graduate or equivalent. Minimum of two years relevant experience, including knowledge of scheduling, registration , and medical terminology Minimum of one (1) year experience as surgery scheduler preferred. Understanding of various insurance plan requirements & authorization processes: government agencies, Medicare and Medicaid and commercial insurance
Must demonstrate the ability to comfortably use a variety of software programs. Ability to type minimum of 40 wpm. High level of interpersonal communication skills required. Understanding and knowledge of various medication relating to patients diagnosis.
Must be detail oriented with exceptional organizations skills.