Job Details

Summary: This role involves obtaining and verifying demographic, clinical, financial, and insurance information to facilitate appointment scheduling for patient tests and procedures. Responsibilities include pre-registering patients, validating medical necessity for Medicare and non-Medicare cases, and ensuring clinical and financial clearance. The scheduler also processes signed physician orders to maintain accurate clinical documentation and performs insurance eligibility verification, pre-certification, referral clearance, and financial education for designated cases.

Major Responsibilities:

• Schedule outpatient appointments for various modalities, excluding biopsy and special procedures, coordinating resources such as equipment, staff, and rooms.
• Manage add-on and same-day appointments, ensuring proper sequencing to minimize patient delays.
• Conduct insurance eligibility and benefit verification using multiple methods and document findings accurately.
• Pre-register patients and provide appointment reminders, including preparation instructions and financial responsibility information.
• Collect patient liabilities such as co-payments, co-insurances, deductibles, and outstanding balances during pre-registration.
• Educate patients, families, and physician offices about diagnostic testing preparations and scheduling instructions.
• Confirm appointments with referring offices and reconcile daily charge reports, addressing any discrepancies.

Education: High school diploma or equivalent required. College coursework in Business, Health Care Administration, or Computer Technology is preferred. Medical terminology knowledge is required within the first year of employment.

Experience: One to two years of insurance or clerical experience in a hospital or medical office setting is preferred.

Skills and Abilities: Must pass pre-employment and post-training testing. Knowledge of insurance processes and payment collection is essential. Proficiency with Microsoft software and excellent verbal and written communication skills are required. The ability to handle complex situations and stress with professionalism is important. Flexibility to work varying shifts and days off may be necessary.

Physical Requirements: Ability to communicate effectively, see, and hear to collect information. Dexterity to operate office equipment. Work environment is an office or call center setting with controlled temperature and low to moderate noise levels. Frequent use of computer screens may cause eyestrain. Ability to lift or move items up to 50 pounds occasionally.