Lead Scheduling and Prior Authorization Rep

Lead Scheduling and Prior Authorization Representative

POSITION DESCRIPTION:

The Scheduling and Prior Authorization Team Lead supports the integrated scheduling department by collaborating with the supervisor to help coordinate daily operations, guide team workflow, and provide day-to-day support to scheduling and prior authorization staff. This role serves as a resource for team members, helps check work processes to ensure the department functions efficiently, and collaborates with the supervisor and other departments to support effective communication and service delivery. The Team Lead promotes consistency in scheduling, registration, insurance verification, and authorization processes while modeling exemplary customer service for both patients and staff.

Supervisory Responsibilities:

• None

Duties/Responsibilities:

• Scheduling
• Pre-registration
• Registration
• Insurance verification
• Pre-encounter collections

• Prior authorization
• Helps supervisor with attendance monitoring and staff schedules.

• Serves as pivotal point of communication for community referring physicians and offices, system patient services, and caregivers to secure resources necessary for patient care.
• Interfaces and/or works directly with nursing units, technologists, physicians, community offices, and other medical facilities to coordinate cases and appointments.
• Receives incoming phone calls related to all aspects of scheduling and coordination of patients and resources.

• Assured all changes to schedules are following policies and alerts proper leadership when out of compliance. Promotes adherence to scheduling practices.

• Collects and evaluates patient demographic, insurance, clinical and non-clinical information.

• Ensure cases and appointments have prior authorization; may coordinate with Financial Counseling to inform patient of monetary responsibility.

• As a condition of employment, completes all assigned training and skills competency.
• Other duties as assigned.

Nothing in this job description restricts MH ability to assign, reassign or eliminate duties and responsibilities of this job at any time. MH does not restrict the tasks that may be assigned. Critical features of this job have been described; those features may be changed at any time due to reasonable accommodation or other reasons deemed appropriate by MH.

Physical Requirements:

• Physically demanding, high-stress environment
• Sitting for extensive periods of time

• Ability to lift, move, push, or pull a minimum of fifteen pounds.

Required Skills/Abilities:

• Knowledge of hospital and physician access management processes.
• Clear, effective communication skills
• Must be a supportive team member, contribute to and be an example of teamwork.
• Ability to deal tactfully with providers, personnel, residents, family members, visitors, government agencies, and the public.
• Excellent customer service skills.
• Able to communicate effectively in English, both verbally and in writing.
• Basic computer skills, including ability to navigate electronic medical record systems.
• Knowledge of medical terminology
• Meticulous
• May work beyond normal working hours and on weekends holidays when necessary.
• Must be able to pass a background check and drug screening.

Education/Experience:

• High school diploma or equivalent required.
• College degree preferred.
• One to three (1-3) years’ experience in healthcare scheduling, authorization, customer service, or financial counseling.
• Knowledge of medical terminology
• Basic computer knowledge, data entry, and/or word processing.

Licenses/Certifications:

• None