Centralized Scheduler

Ocean Beach Health•Ilwaco, WA

8d•Onsite

About The Position

Join Our Team as a full-time Centralized Scheduler at Ocean Beach Health! Are you a dedicated individual looking for meaningful work, and the opportunity to grow in a mission-driven, supportive environment? At Ocean Beach Health, we're looking for compassionate people to join our team and make a real difference in the lives of our community members. The Centralized Scheduler is responsible for hospital & clinic referrals, as well as the efficient and timely scheduling of appointments for all inpatient and outpatient procedures. Duties include answering multiple telephone lines, directing and transferring calls and taking messages. This person is responsible for the accurate and timely review, disposition, documentation, and system input of all prior authorization requests. The Centralized Scheduler will receive inbound and initiated outboard calls to insurance carriers requested prior authorizations for services provided at Ocean Beach Hospital or Clinics. This person must have the ability to work cooperatively in a team environment and support Healthcare Access.

Requirements

High School Graduate
Extensive medical terminology, insurance verification or healthcare experience.
Comprehensive knowledge of EMR software or medical billing software, computer hardware, software, peripheral equipment, and applications.
Knowledge of spreadsheet/word processing/data entry skills both speed and accuracy required.
Current working experience with commercial/governmental insurance carriers.
Excellent communication, customer service and problem-solving skills.
Effectively work in a demanding healthcare environment.
Establish and maintain effective working relation with all departments and staff.
Strong organizational skills and ability to work in a team environment.
Able to maintain confidentiality regarding sensitive and confidential issues.
Ability to effectively manage and prioritize tasks.
Positive patient focused attitude.

Responsibilities

Answer multiple telephone lines, directing and transferring calls and taking messages.
Accurate and timely review, disposition, documentation, and system input of all prior authorization requests.
Receive inbound and initiated outboard calls to insurance carriers requested prior authorizations for services provided at Ocean Beach Hospital or Clinics.
Contacts health plans or payers to gather policy benefits/limitations, completes eligibility and benefits verification of services provided by the carrier and obtains authorization for services.
Enters deductible amount, co-payments, effective date, pre-existing levels of care, authorizations numbers, visit limitations, documentation required to process claims in EMR system.
Identifies potential payer sources, verifies benefits with payer sources (as required by department organizations and obtains initial authorization from the authorizing entity.
Establishes primary payers and documents conversation and decisions with payer sources on appropriate form.
Receiving and reviewing prior authorization requests from the hospital and clinics via telephone, fax, email, or surface mail, if not obtained service will need to be rescheduled.
Provide issue resolve patient care issues and when appropriate refer to Manager.
Handle high call volume, workload and multi-task.
Provide documentation of eligibility, benefits, and authorization.
Works closely with health plans/payers and maintains strong business relationships.
Adheres to and participates in Ocean Beach Hospital and Clinics policy and procedures and attend department meetings and mandatory meetings.
Provides cost-of-service estimates based per patient request.
Completes all training on time.
Contributes to a culture of Patient Centered Care.
Contributes to a safe work environment.
Serves as a mentor to co-workers.
Maintains practices of financial stewardship.
Regular and punctual attendance required.
Must be able to respond to emergencies.