Authorization/Scheduling Coordinator

The Hospital Authority of Miller County•Colquitt, GA

About The Position

The Patient Access Authorization Scheduler Coordinator completes accurate pre-registration, registration, and scheduling for hospital patients. The role verifies and documents insurance coverage; obtains pre-certifications and authorizations; answers questions and explains policies; verifies pre-authorization for exams; informs patients of scheduled procedures and estimated financial responsibility; and performs related duties. The coordinator works with patients, physician offices, clinical staff, insurance representatives, schedulers, and hospital departments to prepare patient information and support timely, accurate access to care. The position also handles calls, collects and balances patient payments, documents eligibility and authorization findings, follows up on pending authorizations, escalates complex issues, and maintains patient confidentiality and compliance with applicable policies and regulations. The role supports the organization’s mission to deliver superior, safe, cost-effective healthcare. Employees are expected to maintain current knowledge, complete required education and competency evaluations, meet quality and productivity standards, adapt positively to change, and contribute to team-based results. Duties may change and other duties may be assigned.

Requirements

High school graduate or equivalent.
At least three years of relevant healthcare experience.
Previous appointment-scheduling experience in a healthcare environment, such as a physician office, clinic, or hospital.
Strong understanding of medical terminology, ICD-10, and CPT coding.
Familiarity with insurance plans, including HMOs, PPOs, and government programs.
Proficiency with computer systems and software, including electronic health records and payer portals.
Proficiency with Microsoft Outlook, Word, and Excel, and ability to navigate websites and systems such as Availity, MyAbility, Relias, and Cerner.
Accurate data-entry skills.
Excellent communication, interpersonal, customer-service, written, and verbal skills; ability to communicate in English verbally and in writing.
Ability to communicate effectively with patients, physicians, clinical staff, and insurance representatives regarding authorization status and requirements.
Strong organizational skills and attention to detail.
Ability to follow up on pending authorizations and proactively address issues or denials.
Ability to maintain operational knowledge of insurance requirements needed to achieve optimal reimbursement.
Ability to meet quality, productivity, attendance, confidentiality, and compliance expectations.

Nice To Haves

Certified Patient Account Representative (CPAR) certification.
Certified Revenue Cycle Representative (CRCR) certification.
Working knowledge of governmental regulations and other reimbursement criteria.
Experience in patient registration, verification, and authorization in a medical center or comparable institution.
Additional language skills.

Responsibilities

Complete accurate pre-registration, registration, and scheduling of hospital patients.
Schedule therapy and other procedures as necessary, and communicate scheduling changes to designated personnel.
Pre-register at least 98% of scheduled patients a minimum of three business days before arrival.
Obtain, validate, and accurately enter patient demographic and insurance information in the computer system.
Obtain required signatures and forms, including ensuring the MSP Questionnaire is completed for every Medicare registration.
Work cooperatively with physician office staff, schedulers, and hospital departments to prepare required information before patient arrival.
Use online programs and contact insurers as needed to verify eligibility and benefits and obtain pre-authorizations and pre-certifications; document findings on patient accounts.
Follow up on pending authorizations, address issues or denials, escalate complex issues, and keep the Department Director apprised of authorization delays.
Inform patients about scheduled procedures and estimated patient responsibility, explain policies and the authorization process, and assist with insurance coverage questions.
Collect applicable co-payments, deductibles, and co-insurance; log cash, generate receipts, maintain balanced cash, and meet monthly collection goals.
Answer and direct telephone calls professionally, transfer calls appropriately, and assist with internal calls when requested.
Provide professional, customer-focused communication to patients, families, staff, physicians, insurance representatives, and other contacts.
Meet established individual and team quality and productivity standards and track productivity when requested.
Maintain current knowledge of scheduling, registration, insurance verification, and patient registration processes, including coverage for absent team members.
Maintain patient confidentiality and follow HIPAA guidelines, organizational policies, ethical business practices, and regulatory requirements.
Attend required staff meetings, in-services, educational programs, annual reviews, and skills evaluations; maintain competencies and complete educational requirements.
Follow time and attendance standards, dress code, identification, and time-clock procedures.
Report suspected illegal or unethical behavior and concerns to a supervisor or the Compliance Officer.
Perform other duties as assigned.