Scheduler and Authorization Specialist | Urology | Full Time

Job Duties and Responsibilities:

• Monitor incoming orders and gathers all information needed for authorization and scheduling.
• Submit for prior authorization with required documentation to the insurance company.
• Ensure valid authorization for each needed procedure or visit.
• Submit required medical and financial information to the surgery center/hospital as needed.
• Maintain consistent follow-up on the status of all prior authorization requests.
• Responsible for authorization maintenance, tracking, and follow-up.
• Responsible for entering approved authorizations into the EHR.
• Responsible for scanning/faxing authorization notes as appropriate.
• Contacts primary care physician offices regarding referrals if needed.
• Maintain effective communication with supervisor and care team.
• Maintain appropriate, collaborative communication with the surgery center and hospital.
• Ensure that patient's chart is up to date with all information.
• Maintain patient confidentiality.
• Perform other related duties as directed or required.

Required Qualifications:

• Minimum of one year of insurance verification experience.
• Minimum of two years of experience in a medical office environment.

Performance Expectations:

• Knowledge of clinic policies and procedures.
• Professional telephone courtesy.
• Knowledge of medical terminology and insurance practices.
• Knowledge of computer programs and applications and use of Electronic Health Records systems.
• Knowledge of grammar, spelling, and punctuation to type from draft copy and review and edit reports and correspondence.
• Knowledge of basic arithmetic to make calculations, balance and reconcile figures, and make changes accurately.
• Understand and abide by all corporate compliance, HIPAA, and Security policies and code of conduct by displaying ethical behavior as it applies to the scope and authority of the job. Adheres to the company's Code of Conduct and Business Ethics.