What are the responsibilities and job description for the Scheduling and Authorization Specialist position at Faith Regional Health Services?
Work Status Details : Full Time | 80.00 Hours Every Two Weeks
Exempt from Overtime : Non-Exempt
Shift Details : 0830-1700 M-TH, 0800-430 F
Department : Central Scheduling | Reports To: Manager-Patient Financial Services-PT Experience
The mission of Faith Regional Health Services is to serve Christ by providing all people with exemplary medical services in an environment of love and care.
Summary:
The Scheduling and Authorization Specialist , working under the direction of the Patient Financial Services (PFS) Manager, is responsible for scheduling all outpatient services referred by physicians and/or their staff. This position coordinates activities with other schedulers and ancillary departments and monitors for other requirements established by third party payers. Confirms reservation dates and times with patients and completes scheduling reports for staff and physicians in accordance with policy. Obtains and verifies any documentation necessary to complete scheduled appointments. This position obtains and document s insurance authorization prior to scheduled services as well as following up on non-scheduled services requiring pre-authorization. Coordinates communication of documented information to a ppropriate parties such as Registration , Ancillary Departments , and Utilization Review . Works closely with financial counseling and various areas of patient accounting as necessary and assigned .
The listing of job duties contained in this job description is not all inclusive. Duties may be added or subtracted at any time due to the needs of the organization.
Responsibilities:
Essential Job Duties and Responsibilities:
- This position is responsible for the Pre-authorization process; works accounts that require follow up and/or as identified as lacking appropriate pre-authorizations. Will regularly review various dept. schedules and orders to ensure that all applicable pre-authorizations are requested and confirmed either by phoning insurance company and/or verification with physicians’ offices.
- This position is responsible for obtaining preauthorization for procedures from insurance companies directly when physician’s clinic is unable to do so and/or insurance company allows.
- This position ensures that all appropriate scanning and documentation of pre-certification, benefit and/or any/all required information gathered is clearly and concisely scanned and/or entered into the appropriate patient account and systems.
- This position must maintain a good working knowledge of insurance companies requiring pre-approval, keep data base current, utilizing software and internet sites for information/verification.
- Position requires a basic working knowledge of CPT and ICD-10 coding and medical terminology.
- Coordinates the scheduling of patients for the various Outpatient Tests/Procedures.
- Responsible for coordinating with multiple ancillary departments for the purpose of scheduling patients.
- Follows up with ordering provider offices to ensure supporting documentation is received timely and accurately supports the test/procedure scheduled.
- Loads necessary order/supporting procedure documentation into Media Manager for all departments to be able to access.
- Obtains a signed physician order with a valid diagnosis for all scheduled tests/procedures.
- Locates orders placed in EPIC and schedules tests/procedures based on the order placed.
- Collects basic, preliminary information for Registration so they may pre-register the patients.
- Provides instructions for the test/procedure scheduled, arrival times & locations to offices and/or patients for the purpose of scheduling.
- Enters outside physician orders in EPIC, transcribes the order and schedules the test, ensuring they all match. Ensures that any supporting documentation that supports the outpatient’s tests/procedures is entered into EPIC.
Hours will be dependent on patient census and workload. Ability and willingness to work a flexible schedule, to include after-hours and weekends as necessary.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Other information:
Job Requirements:
The requirements listed below must be representative of the knowledge, skills, minimum education, training, licensure, experience, and/or ability required.
EDUCATION (Minimum Requirements for Position):
GED or High School Diploma required.
Previous Experience Requirements:
EXPERIENCE:
Previous healthcare experience preferred.
1 year of previous experience in healthcare or customer service preferred.
Skills/Knowledge Requirements:
SKILLS (If Applicable):
Language Skills – Ability to read, write, speak, and understand the English language required.
KNOWLEDGE (If Applicable):
Knowledge of CPT, ICD-10 Codes, and Medical Terminology preferred.
Faith Regional Health Services is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.