Prior Authorization/ Scheduling Specialist

Richmondheart; Mechanicsville, Northern (VA, KY); Hybrid; USD 42,000 - 65,000; Full time

Job summary

Richmondheart is seeking an experienced medical practice scheduler to organize cardiac procedures and obtain required prior authorizations. Candidates should have 3+ years in medical scheduling, including surgical scheduling, with strong authorization knowledge.

Athena EMR experience is strongly preferred. The Scheduler/Authorization Specialist will work collaboratively with internal and external departments to ensure timely patient care and accurate records, supporting efficient workflow and

Qualifications

• Three years medical office experience.
• Excellent telephone and interpersonal skills.
• Experience and/or training in medical terminology.
• Knowledge of hospital scheduling policies and procedures.
• Proficient in computer usage and appointment scheduling.
• Experience with insurance pre-authorizations.

Responsibilities

• Schedule and reschedule patient appointments for visits, testing, procedures, and follow-ups.
• Obtain/confirm patient information to maintain accurate records.
• Schedule in line with practice policies to ensure payer reimbursement.
• Obtain all pre-authorizations from third-party payors.
• Review pending authorizations daily and decide if follow-up is needed.
• Provide payers with clinical information for authorization requests.
• Communicate with front office if authorization isn't obtained within 48 hours.
• Perform other duties as assigned.

Skills

Medical office experience

Telephone skills

Interpersonal skills

Medical terminology

Hospital scheduling policies

Computer usage

Appointment scheduling

Insurance pre-authorizations

Tools

Athena EMR

Job description

Description

Our private cardiology practice is seeking an experienced medical practice scheduler to schedule cardiac procedures and to obtain associated prior authorizations.

Qualified applicants will have 3+ years of medical scheduling experience, including surgical scheduling, and experience in obtaining prior authorizations for procedures and diagnostic testing. Candidate must have strong knowledge of payor prior authorization requirements and processes. Athena EMR experience strongly preferred.

This position performs a wide variety of duties and responsibilities in a manner that results in timely, efficient and competent patient care. The Scheduler/Authorization Specialist must work collaboratively with other internal and external departments, in support of direct patient services, exhibiting flexibility and a can-do attitude, and fostering an environment which promotes patient comfort and trust. The position must exemplify the core values and mission of the practice and provide care that reflects initiative and responsibility indicative of professional expectations.

DUTIES & RESPONSIBILITIES

• Schedule (and as needed, reschedule) patient appointments for office visits, diagnostic testing and procedures and necessary follow up appointments for same.
• Obtain and/or confirm basic patient information, e.g., home phone, place of work, and insurance policy number, as needed to maintain current patient information in the electronic medical record.
• Schedule in accordance with practice policies to ensure services performed will be compensated by payers.
• Responsible for obtaining all pre-authorizations from third-party payors for scheduled patients.
• Review all pending authorizations daily and determine if/when a follow up call is necessary.
• Provide payers with relevant clinical information associated with authorization request.
• Communicate with front office if unable to obtain authorization within 48 hours of the appointment.
• Other miscellaneous duties as assigned

Requirements

SKILLS & QUALIFICATIONS

• Three years medical office experience
• Excellent telephone and interpersonal skills
• Experience and/or training in:
• Medical terminology
• Hospital scheduling policies and procedures
• Computer usage
• Appointment scheduling
• Insurance pre-authorizations