Care Coordinator Auth Scheduling Specialist

Advocate Health and Hospitals Corporation • Charlotte, NC

2d • Onsite

About The Position

The Care Coordinator Auth Scheduling Specialist is responsible for scheduling surgeries for patients and physicians. This role involves contacting facilities, providing necessary scheduling information, ensuring special equipment is available, and coordinating and confirming schedules. The specialist also ensures all surgical requirements are met, including patient history, physicals, and ancillary testing, and forwards this information to the appropriate parties. Additionally, they provide general information and education on pre- and post-operative care to patients and families, assessing when further education is needed and referring back to a nurse if necessary. The role also involves screening referrals and pre-certification requests for completeness, coverage, network affiliation, and medical appropriateness, collaborating with management and insurance companies on various managed care issues. The specialist directs surgeries to the appropriate facility for maximum reimbursement and coordinates insurance issues with pre-registration or credit departments. They act as a liaison between physicians, patients, patient care staff, families, vendors, providers, and insurers regarding referrals and pre-authorizations.

Requirements

• High School Graduate.
• Typically requires 1 year of experience in scheduling.
• Ability to provide good customer service and multi-task on a regular basis.
• Knowledge of insurance coverage.
• Strong verbal, interpersonal, and written communication skills.
• Ability to pay close attention to detail in a fast-paced environment.
• Must have knowledge on how to navigate on the Internet.
• Proficient computer and keyboarding skills.
• Strong ability to prioritize work flow.

Responsibilities

• Schedules surgeries for patients and physicians.
• Contacts facilities and provides necessary scheduling information.
• Ensures special equipment is available and coordinates/confirms schedules.
• Assures all necessary requirements for surgery are met, including patient's history, physical, and ancillary testing results.
• Forwards necessary information to the facility and/or physician.
• Provides general information and education regarding pre and post-operative care with patient and/or family members.
• Assesses when further education is needed and refers back to the nurse as indicated.
• Redirects patients back to specialists/providers and facilities where appropriate.
• Screens referrals and pre-certification requests for completeness, coverage, network affiliation and medical appropriateness.
• Collaborates with the manager and/or insurance company to review referrals and/or pre-certification, policies, practice guidelines, denials, patient noncompliance, medical necessity, physician issues and other managed care issues as needed.
• Directs surgeries to appropriate facility to allow for maximum reimbursement.
• Coordinates insurance issues with pre-registration and/or credit department when appropriate.
• Acts as a liaison with physicians, patients, patient care staff, families, vendors/providers and insurers regarding referrals and preauthorizations.

Benefits

• Competitive compensation
• Generous retirement offerings
• Programs that invest in your career development
• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED