Scheduler-Full Time-Days

Cape Fear Valley Health; Fayetteville, Northern (NC, KY); On-site; USD 32,000 - 40,000; Full time

Job summary

Cape Fear Valley Health is seeking a Clerical Scheduler to handle pre-registration, insurance verification, and scheduling for orthopedics and related services at Fayetteville, NC. The role ensures clinical and financial clearance and communicates with patients, families, and referring offices.

The incumbent will verify eligibility, coordinate test appointments, collect patient liabilities, and provide education on scheduling and financial responsibilities.

Qualifications

• High school diploma or equivalent required.
• Business/Health Care Administration or Computer Technology coursework preferred.
• Medical terminology knowledge within one year of employment.
• 1 year insurance/clerical experience preferred.
• English reading, writing and speaking proficiency.
• Must pass pre-employment and post-training testing.
• Experience with Microsoft Office applications.
• Excellent verbal and written communication and customer service skills.
• Ability to handle complexity and stress with changing needs of patients and department hours.

Responsibilities

• Receive orders and schedule outpatient appointments for all modalities except biopsy and special procedures.
• Determine scheduling requirements and allocate resources (equipment, staff, room).
• Coordinate add-on and same-day appointments as required.
• Ensure proper test sequencing with minimal patient delays when multiple tests are needed.
• Perform insurance eligibility/benefit verification and pre-certification/authorization.
• Pre-register patients for upcoming visit(s).
• Notify patients of appointment details and financial responsibilities.
• Validate medical necessity for Medicare and Non-Medicare cases.
• Collect patient co-pays, co-insurances, deductibles and balances at pre-registration.
• Provide patient, family and physician education during scheduling.
• Sends/communicates appointment confirmations to referring office.
• Reconciles charge reports daily and communicates errors to staff.
• Other duties as assigned.

Skills

English proficiency

Customer service

Microsoft Office

Insurance knowledge

Communication skills

Problem solving

Education

High school diploma or equivalent

Business/Health Care Admin or Computer Tech coursework preferred

Medical terminology knowledge within 1 year

Job description

Summary

Facility Cape Fear Orthopedics FC Location Fayetteville, North Carolina Department CF Orthopedics & Sports Medicine - Ferncreek Job Family Clerical Work Shift Days (United States of America).

Summary Obtains and/or verifies demographic, clinical, financial, and insurance information in the process of appointment making for patient tests and procedures, pre-registering and financial clearing for service delivery. Validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Additionally, the incumbent obtains and processes signed physician orders to ensure clinical documentation for care delivery. The incumbent conducts online insurance eligibility/benefit verification, pre-certification/authorization, referral clearance and financial education on designated cases. As appropriate, the incumbent notifies patient/guarantor and collects patient liabilities, and refers appropriate cases to resource counseling for follow-up and consultation.

Major Job Functions

• Receive orders and schedule outpatient appointments for all modalities except biopsy and special procedures and all radiology outpatient facilities
• Determines proper scheduling requirements and/or limitations according to requested tests/procedures and schedules resources (equipment, staff, room, etc.)
• Coordinates add-on and same-day appointments as required
• Ensures proper test sequencing with minimal patient delays, when multiple testing is required.
• Performs insurance eligibility/benefit verification, utilizing a variety of mechanisms (EDI transactions, web access and by calling payers) and documenting information within the appropriate registration system; supporting with reference number.
• Pre-registers the patient for upcoming visit(s).
• Calls patient to remind of appointment date, time, location, and preparation for procedures following protocols; as well as informs the patient of their financial responsibility, answer questions and give directions.
• Validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance.
• Informs patient/guarantor of their liabilities and collects appropriate patient co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration.
• Provides patient, family and physician office education during scheduling process to inform them of preparations needed for diagnostic testing and proper scheduling instructions
• Sends and/or communicates appointment confirmation to referring office
• Reconciles charge reports daily and communicates errors to staff
• Other duties as assigned

Minimum Qualifications

• Education and Formal Training: High school diploma or equivalent required
• College courses in Business or Health Care Administration and/or Computer Technology preferred
• Medical terminology required within one year of employment
• Work Experience: 1 year insurance/clerical experience within a hospital or medical office setting preferred
• Knowledge, Skills, and Abilities Required: Proficiency in reading, writing, and speaking the English language
• Must pass pre-employment testing and post-training testing
• Must have knowledge of insurance and collection of payments
• Must have experience with Microsoft software
• Must possess excellent verbal and written communication skills, customer service skills and problem-solving abilities
• Must be multi-skilled with the ability to appropriately handle complexity and stress with the changing needs of the patients, families, visitors, and the Health System
• May be required to periodically rotate shifts and regular days off
• All system employees must have the flexibility to meet the department hours of operation

Physical Requirements

Must be able to communicate orally, see, and hear to collect information Must have dexterity to operate office equipment Position operates in an office, call center environment Work area is well-lit, temperature controlled and free from hazards The incumbent is subject to eyestrain due to the many hours spent looking at a CRT screen The noise level is low to moderate Answers telephone calls, uses personal computer and other business machines extensively Bends, reaches, pushes and pulls file drawers to file records and reports Regularly lift or move up to 10 pounds, frequently lift or move up to 25 pounds and occasionally lift or move up to 50 pounds.

Required Licenses and Certifications

Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity For exceptional healthcare come to Cape Fear Valley Health where caring employees are committed to integrity, patient-centeredness and excellence throughout the entire healthcare process.

Cape Fear Valley is a 950-bed, 8-hospital regional health system, the 8th largest in North Carolina, with more than 1 million inpatient and outpatients annually. A private not-for-profit organization with over 7,000 employees and 850 physicians. Our employees and physicians proudly serve a seven-county region of southeastern North Carolina, including Fayetteville, Fort Bragg, Hope Mills, Raeford, Lumberton, Elizabethtown, Clinton, Lillington, Dunn and beyond. Our medical facilities include Cape Fear Valley Medical Center, Highsmith-Rainey Specialty Hospital, Cape Fear Valley Rehabilitation Center, Behavioral Health Care, Bladen County Hospital, Hoke Hospital, Central Harnett Hospital, Betsy Johnson Hospital, as well as more than 60 medical offices and specialty care clinics spread throughout the Cape Fear region.