Scheduling/Authorization Coordinator - NCPS - Galloway (Full Time, Days)

Nicklaus Children's Health System; Ohio; On-site; USD 25,000 - 30,000; Full time

Job summary

Nicklaus Children’s Health System is seeking a Clerical/Administrative professional to secure insurance authorizations and manage pre-registration and scheduling for hospital visits and procedures. The role involves coordinating with clinical staff, handling insurance documentation, and ensuring accurate records.

The ideal candidate will have a high school diploma or equivalent, strong customer service skills, and the ability to communicate effectively in English and Spanish.

Qualifications

• High school education or equivalent preferred.
• Excellent customer service skills.
• Critical thinking skills needed.
• Bilingual in English/Spanish preferred.

Responsibilities

• Secures insurance authorization for outpatient and diagnostic testing, consultations, and outpatient procedures.
• Schedules appointments and procedures, verifies appointments, and processes documentation.
• Coordinates collection and submittal of insurance information from clinical/support staff.
• Escalates authorization issues and coordinates peer-to-peer review.
• Coordinates with clinical team and communicates managed care requests via workflows.
• Documents accurate insurance notes and authorizations.
• Answers telephones, routes calls, takes messages, and relays to staff.
• Follows up with patients for return visits, missed appointments, and cancellations.

Skills

Customer service

Critical thinking

Bilingual English/Spanish

Education

High school diploma or equivalent

Job description

Job Summary

Responsible for securing insurance authorizations for patients and performs pre-registration and scheduling functions for hospital visits and procedures.

Minimum Job Requirements

• 2- 3 years of medical insurance and billing experience required.
• Previous physician office or ambulatory experience preferred.

Essential Duties and Responsibilities

• Secures insurance authorization for all outpatient and diagnostic testing, consultation, and outpatient procedures.
• Schedules appointments and procedures, verifies medical appointments, and processes medical documentation.
• Coordinates the collection and submittal of additional insurance information from clinical/support staff.
• Escalates any authorization issues and coordinates peer-to-peer review.
• Coordinates with clinical team and communicates managed care requests via established work flows.
• Documents adequate and accurate records of insurance notes and authorizations.
• Answers telephones, routes calls to appropriate staff, takes accurate phone messages, and relays messages to staff.
• Follows-up with patients for return visits, missed appointments, and cancellations.

Knowledge/Skills/Abilities

• High school education or equivalent preferred.
• Bilingual in English/Spanish preferred.
• Excellent customer service skills.
• Critical thinking skills needed.

(EOE DFW)

Job: Clerical/Administrative

Department: NCPS PCC GALLOWAY-3100-461014

Job Status: Professional