Scheduling & Auth Specialist 2-HOPD

Loma Linda University Health; Loma Linda (CA, AZ); On-site; USD 45,000 - 65,000; Full time

Job summary

Loma Linda University Health is seeking a Scheduling & Auth Specialist 2 in the HOPD Pediatric Neurosurgery department. You will be responsible for financially clearing insurance verifications, reviewing medical records, and coordinating authorizations with payers.

Collaborate with the Patient Business Office, assist with reimbursement and authorization processes, and support denials and appeals. Strong communication in English and proficiency with office software are essential.

Qualifications

• Associate's Degree required.
• Minimum three years of related experience.
• Healthcare experience preferred.
• Medical coding certification preferred.

Responsibilities

• Financially clear insurance verifications for services.
• Review medical records and obtain required documentation for authorizations.
• Interface with payers to extend authorization for treatment and support denials/appeals.

Skills

Insurance verifications

ICD/CPT coding

Professional communication

Education

Associate's degree

Tools

Word

Excel

Outlook

PowerPoint

Job description

Department: HOPD Pediatric Neurosurgery

Job Summary: The Scheduling & Auth Specialist 2 is responsible for financially clearing insurance verifications for all services and patient financial classifications, reviewing medical records, interfaces with payers to extend authorization for treatment, collaborates with Patient Business Office (PBO), assists with reimbursement and authorization according to contracts, and supports the denials and appeals process. Obtains pertinent documentation to support authorization requests. Serves as the liaison between PBO, Central Authorization, physicians, outside medical groups (OMG), various insurance carriers, patients, and all departments for office visits, in-patient, and out-patient services. The duties outlined in this Job Description will be an important part of our Hospital Outpatient Department strategy for the delivery of care that is consistent with our mission, vision, and values. This role is therefore accountable to the governance structure of the (Loma Linda University Medical Center) (Loma Linda University Children's Hospital). Performs other duties as needed.
Education and Experience: Associate's Degree required. Minimum three years of related experience required. Minimum one year of healthcare experience preferred. Experience may be considered in lieu of degree.
Knowledge and Skills: Knowledge of various insurance types and their guidelines, including the ability to read and interpret EOB's. Working knowledge of current ICD and CPT coding systems. Able to read; write legibly; speak in English with professional quality; use computer, printer, and software programs necessary to the position (e.g., "Word, Excel, Outlook, PowerPoint"). Operate/troubleshoot basic office equipment required for the position. Essential Interpersonal Skills: Able to relate and communicate positively, effectively, and professionally with others; work calmly and respond courteously when under pressure; collaborate and accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.

Licensures and Certifications: Medical coding certification preferred.

Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.