Scheduler

CVRMC; Globe (AZ); On-site; USD 38,000 - 48,000; Full time

Job summary

CVRMC in Globe, AZ is seeking an Authorization/Scheduling Clerk to verify prior authorization and pre-certification requirements, and to coordinate referrals for continuation of treatment. The role requires working closely with clinic offices, hospital staff and payors to ensure patient care is authorized efficiently.

The ideal candidate will verify insurance eligibility and benefits, appeal denials, and track authorizations to close care gaps while maintaining professional standards.

Qualifications

• High School diploma or GED equivalent.
• BLS/CPR Certification required.
• First Responder or EMT certification preferred.
• One-year hospital registration or medical office experience with knowledge of insurance company prior authorization, pre-certification, insurance benefits and how it relates to registration preferred.
• Skilled at multitask abilities, detail oriented self starter and self managed. Legible handwriting.
• Maintains self with professionalism at all times.
• Basic knowledge of computers. Previous experience with Meditech system or mainframe system preferred.

Responsibilities

• Verify prior authorization and pre-certification requirements.
• Obtain authorization and pre-certification when required by the insurer.
• Notify payors as required and coordinate referral orders for continuation of treatment.
• Work with clinic offices, hospital staff and payors to ensure patient care is authorized.
• Verify patient insurance eligibility and benefits.
• Appeal prior authorization denials and obtain retro authorizations as needed.
• Track and manage authorizations and referrals to close patient care gaps and document for team awareness.

Job description

The Authorization/Scheduling Clerk is responsible for verifying prior authorization and pre-certification requirements. Obtain authorization and pre-certification when required by the insurance company. The clerk will also provide notification to the payer when required. Coordinates referral orders for continuation of treatment. Works directly with clinic offices, hospital staff and payors to ensure patient care is authorized for services. Will verify patient insurance eligibility and benefits. Appeals prior authorization denials, obtains retro authorizations and completes all payor requirements necessary for authorization approval. The position is responsible for tracking and managing the authorization and referrals with the intention and outcome to close any patient care gaps along with providing documentation to promote team awareness.

QUALIFICATIONS:

• High School diploma or GED equivalent
• BLS/CPR Certification required
• First Responder or EMT certification preferred
• One-year hospital registration or medical office experience with knowledge of insurance company prior authorization, pre-certification, insurance benefits and how it relates to registration preferred.
• Skilled at multitask abilities, detail oriented self starter and self managed. Legible handwriting.
• Maintains self with professionalism at all times.
• Basic knowledge of computers. Previous experience with Meditech system or mainframe system preferred.