Scheduling & Auth Specialist 2-HOPD

Socket.dev; Loma Linda (CA); On-site; USD 60,000 - 76,000; Full time

Job summary

Loma Linda University Health is seeking a Scheduling & Auth Specialist 2 for the HOPD Pediatric Cardiology/CT Surgery department. The role focuses on financially clearing insurance verifications and obtaining necessary authorizations for services.

You will collaborate with the Patient Business Office, assist with reimbursements and denials management, and liaise with payers, physicians, and departments to support efficient outpatient and inpatient care.

Qualifications

• 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.

Responsibilities

• Handle financial clearance for insurance verifications.
• Review patient records and obtain authorization from payers.
• Serve as liaison between PBO, Central Authorization, physicians, OMGs, carriers, patients and departments.
• Support denials and appeals process.

Skills

Insurance guidelines

ICD/CPT coding

English communication

MS Office

Education

Associate's Degree

Tools

Word

Excel

Outlook

PowerPoint

Job description

Department: HOPD Pediatric Cardiology/CT Surgery

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.

Loma Linda University Health is a Seventh-day Adventist, faith and values based Christian institution. Candidates must understand and embrace the mission, purpose, and identity of Loma Linda and its affiliated entities.

We are an equal opportunity employer committed to the principles of diversity. We provide equal opportunities in all aspects of the employment process to every individual, regardless of gender, race, color, age, national origin, ancestry, physical or mental disability, marital or veteran status, genetic information or any other characteristic protected by law. In addition, we will provide reasonable accommodations for otherwise qualified individuals requesting an accommodation due to a disability. If you need accommodation assistance with accessing our job listings or completing an application, or during any other phase of employment with us, please contact Human Resources Management at [phone].

Loma Linda University Health Care is a religiously-qualified Equal Opportunity Employer under Title VII of Civil Rights Act of 1964. No question on this application is asked for the purpose of unlawfully limiting or excluding any applicant’s consideration for employment because of race, color, religion, gender, age, national origin, disability, genetic information, or any other status protected by applicable law. If you need a reasonable accommodation in the hiring process, please notify Human Resource Management.

We appreciate your interest in Loma Linda and wish you success in your job search!