Scheduler/Authorization Coordinator
Summary: responsible for the coordination of the authorization/scheduling process, including but not limited to submitting clinical documentation, tracking approvals, initiating appeals for denials, and scheduling appointments.
Essential Duties and Responsibilities
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Submit, review, and process pre-authorization requests via insurance portals or phone.
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Collect and send necessary clinical documentation and medical necessity notes.
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Monitor the status of submitted requests and managing denials, including filling appeals.
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Acquire and verify insurance benefits and precertification as required by insurance.
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Obtain and review physician orders for scheduling of outpatient testing.
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Schedule required outpatient testing and procedures for Surgery, Cardiology, and other Outpatient procedures.
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Acquire medical necessity for all Medicare patients and perform net compliance for Medicare patients to adhere to Medicare guidelines.
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Prepare up-front collection documentation and enter patient information into scheduling and registration system, including pre-registration, and insurance authorization documentation.
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Other duties as assigned.
****MMH is an equal opportunity employer****
Minimum Qualifications: High school diploma or GED required. Previous hospital, medical scheduling/billing office or collections, or prior authorization experience required. Prior clinical experience preferred.
