Authorization Scheduling Coordinator - Community Health Center

Summary Of Position

Analyzes patient's ability to pay through verification of insurance, arranges payment plans and investigates pay options through third party resources. Pre-authorizes procedures and surgeries for facility and physician. Schedules follow up appointments and coordinates multiple appointments for patients throughout the Patient Centered Medical Home (PCMH) and ancillary services. Updates patient registration and completes/updates forms as needed.

Qualifications

Education:

• High School Diploma or GED preferred
  
  

Experience

• Minimum two years previous office administrative/clerical experience preferred
• Requires detailed knowledge of business office processes
• Patient Centered Medical Home experience preferred
  
  

Knowledge/Skills/Abilities

• Typing and computer literacy
• Reading and writing skills, organizing and filing, professional phone etiquette
• Sufficient computer skills are required to complete an online application and the pre-employment annual learning requirements
• In compliance with patient safety standards, must be able to effectively communicate in English; Bilingual abilities preferred
  
  

Certifications/Licensure

• n/a
  
  

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is frequently required to walk, stand, sit, and talk or hear.
• The employee is occasionally required to use hands to finger, handle, feel or operate objects, tools, or controls; and reach with hands and arms.
• The employee is occasionally required to climb or balance; stoop, kneel, crouch, or crawl.
• Specific vision abilities required by this job include close vision, color vision, and the ability to adjust focus.
• The employee must occasionally lift and/or move up to 25 pounds.
  
  

Working Conditions

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Normal office environment. The noise level in the work environment is usually quiet to moderate while in the office.
• Occasional travel to various health system locations.
  
  

Essential Functions

• Provides consistently exceptional care at all times.
• Ability to prioritize, multi-task and handle emergent situations and critical deadlines.
• Interviews patient and/or guarantor to obtain complete and accurate demographic/financial information to determine patient's ability to pay for services.
• Screens Self-Pay and underinsured patients to determine their financial needs, referring patient to appropriate department for government assistance or Helping Hand program.
• Arranges Payment Plans.
• Requests deposits for upcoming surgeries and/or procedures.
  
  

Verifies Medical necessity of Medicare patients using current online software.

• Contacts insurance company to obtain benefits, eligibility and any necessary authorizations
• Proficient in the use of the all hospital associated software used to complete tasks.
• Faxes appropriate documentation to insurance companies to assure timely response.
• Verifies Medical necessity for Medicare Patients using current online software. Coordinates with other Barton departments to schedule patients for surgical, inpatient and hospital follow up appointments.
• Coordinates multiple appointments in order to offer consecutively scheduled services.
• Responds to the needs of the department by performing other duties, as necessary.