Hospital Scheduler

Jersey Community Hospital•Jerseyville, IL

1d•Onsite

About The Position

Verifies insurance benefits and processes accounts to ensure that patients are preregistered and required insurance authorization and precertifications are obtained prior to the date of service. Communicates with patients and insurance companies regarding coverage and other related matters. Discusses benefits with patients, responds to patient/third party inquiries. Completes insurance verification / pre-certification according to payor requirements. Identifies outpatient procedures that require precertification / second opinion, obtains required information from physician, and pre-certifies inpatient admissions. Works with financial counselor to request pre-payment and informs patients of discounts. Completes Medicare Questionnaire and ensures that medical necessity is established for Medicare / Medicaid patients. Responsible for accurately scheduling diagnostic and/or surgical procedures. Conducts physician office/patient interviews and explains hospital procedure guidelines and policies. Responsible for obtaining complete and accurate clinical, demographic and financial information during the scheduling process. Provides the patient with prep and other appointment instructions. Follows guidelines for special requires / STAT / schedule modification procedures and coordinates communications with clinical areas to accommodate patient requests. Notifies patient of physician order, preauthorization and other financial clearance requirements. Other duties as assigned.

Requirements

High school graduate or equivalent
Excellent communication and interpersonal skills required to discuss financial matters with patients and/or their representative, and to work with all levels of professionals at JCH and in other organizations.
Ability to comprehend large amounts of complex information, and explain complex insurance benefits to patients and/or their representatives.
Ability to respond to quickly changing priorities and patient needs.
Demonstrated computer skills and related experience preferred.

Nice To Haves

Prior medical experience and knowledge of insurance policies and procedures preferred
Medical terminology preferred

Responsibilities

Verifies insurance benefits and processes accounts to ensure that patients are preregistered and required insurance authorization and precertifications are obtained prior to the date of service.
Communicates with patients and insurance companies regarding coverage and other related matters.
Discusses benefits with patients, responds to patient/third party inquiries.
Completes insurance verification / pre-certification according to payor requirements.
Identifies outpatient procedures that require precertification / second opinion, obtains required information from physician, and pre-certifies inpatient admissions.
Works with financial counselor to request pre-payment and informs patients of discounts.
Completes Medicare Questionnaire and ensures that medical necessity is established for Medicare / Medicaid patients.
Accurately schedules diagnostic and/or surgical procedures.
Conducts physician office/patient interviews and explains hospital procedure guidelines and policies.
Obtains complete and accurate clinical, demographic and financial information during the scheduling process.
Provides the patient with prep and other appointment instructions.
Follows guidelines for special requires / STAT / schedule modification procedures and coordinates communications with clinical areas to accommodate patient requests.
Notifies patient of physician order, preauthorization and other financial clearance requirements.
Performs other duties as assigned.