Front Office Scheduler/Prior Authorization Specialist

We are an Ambulatory Surgery Center looking for an individual who is professional, customer-service oriented, detail-focused, and capable of multitasking in a fast-paced healthcare environment. This person plays a key role in ensuring a smooth and professional experience for all patients. This position is responsible for checking patients in and out, submitting for prior-authorizations for out patient procedures, verifying insurance eligibility and benefits, advising patient's of their financial responsibility at the time of service and efficiently managing appointment scheduling. In this role an extensive knowledge of obtaining prior authorizations and verifying insurance benefits for both INN and OON are REQUIRED!!!!

Job Responsibilities

1. Patient Check-In Duties:

• Greet patients upon arrival with professionalism and warmth.
• Collect and update patient demographic and insurance information.
• Ensure all consent and medical history forms are completed.
• Collect co-pays and/or outstanding balances before appointments.
• Notify clinical staff of patient arrival and update the queue accordingly.
• Perform end of day reconciliation.

2. Prior Authorization and Insurance Verification Duties:

• Submit for prior authorizations for outpatient procedures (via phone and various online portals).
• Verify insurance eligibility and benefits for patients prior to scheduled appointments (via phone and various online portals).
• Document coverage details, deductibles, co-insurance, and co-pay amounts in the system.
• Confirm any referrals or authorizations are on file, if required.
• Communicate clearly with patients about their benefits, out-of-pocket responsibilities, and coverage limitations.
• Address any discrepancies or issues with insurance information before the patient is seen.

3. Appointment Scheduling Duties:

• Schedule, reschedule, and cancel appointments using the practice management software (e.g., Advantx, Athenahealth)
• Confirm appointments with patients via phone calls.
• Maintain awareness of appointment types, provider preferences, and time requirements for specific procedures or visits.

Required Qualifications

• High school diploma or equivalent required; associate degree or healthcare certification a plus.
• 2 years experience in a medical or healthcare setting required.
• Knowledge of electronic health records (EHR) or scheduling software (Advantx, Athenahealth) preferred.
• Prior Authorization submission for outpatient procedures.
• Verification of insurance benefits for both INN and OON plans.
• Excellent interpersonal and communication skills.
• Ability to handle multiple tasks while maintaining attention to detail.
• Knowledge of HIPAA regulations and patient confidentiality.
• STRONG desire to work as a team.

Education: High School diploma or equivalent a must

BENEFITS:

• Health Insurance (medical, dental, vision)
• Retirement Plan Options
• PTO and Paid Holidays
• Referral Program Incentive
• And more!

**PLEASE PROVIDE A COVER LETTER ALONG WITH A LIST OF REFERENCES IN ORDER TO BE CONSIDERED**

Job Type: Full-time

Pay: From $1.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Education:

• High school or equivalent (Preferred)

Experience:

• insurance verification: 2 years (Required)
• front office medical: 2 years (Required)

Work Location: In person