Centralized Scheduling/Pre-cert Specialist

William Newton Hospital•Winfield, KS

About The Position

This position plays an integral role in ensuring the smooth operation of our Ancillary Services and maintaining high standards in patient care. As a Centralized Scheduling/Pre-cert Specialist, you will be responsible for coordinating and managing patient appointments and schedules efficiently, while interacting with patients, physicians, and other healthcare providers.

Requirements

Adheres to dress code, appearance is neat, clean and professional.
Completes annual education requirements.
Maintains and ensures patient confidentiality at all times.
Reports to work on time and as scheduled, completes work within designated time.
Wears identification while on duty, uses computerized punch time system correctly.
Attends Hospital in-service and educational opportunities.
Represents the organization in a positive and professional manner.
Complies with all organizational policies regarding ethical business practices.
Works at maintaining a good rapport and a cooperative working relationship with physicians, departments and staff.
Ensures compliance with policies and procedures regarding department operations, fire, safety and infection control.
Communicates the mission, vision and core values of the hospital.
Maintains regulatory requirement, including all state federal and CMS regulations.
You must be able to work independently while also being an effective team player.
Collaboration with other departments and the ability to adapt to changing situations is essential to the role.
Dedication to excellence for our Organization, patients and the community we serve.
High school diploma or equivalent.
Familiarity with medical terminology, healthcare procedures, and the insurance verification process is required.
Ability to read and communicate effectively in English, both verbally and in writing.
You should be proficient in using scheduling software, electronic health record (EHR) systems, and Microsoft Office applications, including Excel, Outlook, Teams/Zoom and Word.
Multi-line phone knowledge.
Strong verbal and written communication skills are essential for interacting professionally with patients, healthcare providers, and internal teams. You should be able to convey information clearly, professionally, politely answer questions, and resolve concerns.
Excellent attention to detail and organizational abilities are crucial in this fast-paced environment. You must be able to prioritize tasks, manage time efficiently, and work under pressure while maintaining accuracy.
The ability to troubleshoot scheduling conflicts, manage patient requests, and resolve issues promptly, time management, and stress management are key parts of this role.

Nice To Haves

Knowledge of CPT/HCPCS codes and ICD -10 codes is preferred but not required.
Minimum 1 year prior experience in a medical office environment, particularly in scheduling, administration, or customer service, is highly beneficial but not mandatory.
Knowledge of platforms such as TruBridge, Availity, other Payer-specific Provider Portals for insurance verification is preferred.

Responsibilities

Appointment Coordination: Effectively manage and coordinate patient appointments, ensuring that schedules are optimized to maximize resource utilization and minimize patient wait times.
Patient and Provider Interaction: Act as a liaison between patients, physicians, and healthcare staff to schedule appointments, relay information, and handle any necessary changes.
Insurance Verification and Authorizations: Verify patient insurance coverage using tools like TruBridge, Availity, Phone calls, and Payer Portals. Obtain necessary prior authorizations for services, ensuring accuracy and compliance with insurance guidelines.
Records Management: Maintain accurate and detailed records of patient appointments, including cancellations and rescheduling. Ensure that all relevant patient data is properly documented.
Customer Service: Provide top-tier customer service by answering patient inquiries, addressing concerns, resolving scheduling conflicts, and accommodating urgent appointment requests.
Department Collaboration: Work closely with other departments, Radiology, Respiratory, Billing, Admissions, Outside Clinics, Lab, and clinical and administrative teams to ensure the smooth coordination of patient care and services.
Scheduling Software Proficiency: Utilize scheduling software to effectively manage appointments, update patient data, and keep track of scheduling needs. You will be responsible for updating insurance information, Name, Addresses, and phone numbers as needed.
HIPAA Compliance: Maintain the confidentiality of patient information at all times in accordance with HIPAA regulations. Ensure all data is handled securely and discreetly.
Meeting Participation: Attend department meetings and training sessions to stay informed about new procedures, tools, and protocols relevant to your role.
Phone and Communication Duties: Answer phone calls, manage inquiries from patients, insurance companies, and healthcare providers, and ensure accurate and efficient communication that supports patient care.
Team Support: Contribute to team efforts by using spreadsheets and other tools to assist in communication and tracking of patient care.
Additional Duties: You will be expected to assist with any other tasks that support the team’s goal of delivering superior patient care, such as helping to schedule patients, up-front collections, no-show calls/rescheduling, reminder calls/texts and Good Faith estimates.