Description:
Convergence Health Elko is seeking a professional and detail-oriented Physician Surgery & Authorization Scheduler. In this role, you will cultivate relationships with physician offices, referral partners, hospitals, and ASC staff, while managing the end-to-end scheduling and insurance authorization process to provide patient-centric services to the patients we serve.
Primary Responsibilities
? Schedules patients for hospital inpatient, outpatient, and ambulatory surgeries to ensure patients are scheduled in an appropriate and timely manner.
? Obtains and manages prior authorizations, pre-certifications, and insurance verifications for all surgical procedures, ensuring approvals are secured from commercial and government payors prior to the date of surgery.
? Interviews patients either in person or by phone to verify demographic and insurance details, and to ensure information is accurate prior to surgery.
? Completes patient instruction forms and appropriate surgical area forms to ensure patients are provided with follow-up appointments, orders, and prescriptions.
? Schedules patient’s pre-operative examination and lab work to ensure completion prior to surgery.
? Collaborates with hospital and Ambulatory Surgery Center (ASC) surgery schedulers to enact efficient utilization of block times.
? Notifies Surgery scheduling clerk to provide priority surgery time.
? Notifies affected staff, services, and departments if a case is rescheduled, canceled, or added to ensure appropriate people are contacted.
? Regular attendance is required to carry out the essential functions of the position.
? Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge, and abilities to perform, within scope, role-specific functions.
? Provides information and updates regarding patients’ surgery schedules and authorization status.
? Assists patients with guidance on financial responsibility, insurance requirements, and filing necessary forms.
? Takes reservations for surgeries and schedules dates based on the availability of the surgeon.
? Orders patients' test results and assesses information from the report to determine if the patient is medically ready for surgery.
? Assures appropriate coordination with other hospital departments when special surgical needs occur.
? Files, collects, and organizes pre- and post-operational data, authorization documentation, and medical necessity chart notes for reference.
? Schedules and manages authorizations for multiple surgeons across various specialties.
? Other duties as assigned.
Requirements:
Qualifications Required
? High school diploma or equivalent required.
? A minimum of three years’ experience working in a medical or dental office.
? Experience with surgery scheduling and a strong working knowledge of medical insurance, CPT/ICD-10 coding, and the prior authorization process preferred.
? Strong project management and multi-tasking skills.
? Proficient in MS Word, Excel, Outlook, and Electronic Medical Records (EMR) systems.
? Ability to act with integrity, professionalism, and confidentiality.
? Promotes positive work culture and teamwork.
? Excellent communication skills; handles challenging situations and insurance appeals with diplomacy without compromising clarity.
? Highly organized, skilled at prioritizing tight deadlines and urgent authorization timelines.
? Able to work with high accuracy and meticulous attention to detail to prevent claim denials.
? Drives ambassador-level service to patients, community partners, and cross-functional teams.
? Demonstrates flexibility and supports changes that improve quality of care, service, and operations.
? Takes initiative to assist other staff in completion of their assignments as needed.
? Ability to work with confidential information and handle protected health information in a manner consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
