Hospital Scheduler

Jersey Community Hospital•Jerseyville, IL

6d•$16 - $21•Onsite

About The Position

The Hospital Scheduler is responsible for verifying insurance benefits, processing accounts to ensure patients are preregistered, and obtaining necessary insurance authorization and precertification before the date of service. This role involves communicating with patients and insurance companies regarding coverage, discussing benefits, and responding to inquiries. The scheduler will identify outpatient procedures requiring precertification, obtain required information from physicians, and pre-certify inpatient admissions. They will also work with financial counselors to request pre-payments and inform patients of discounts, complete Medicare Questionnaires, and ensure medical necessity for Medicare/Medicaid patients. Additionally, the scheduler is responsible for accurately scheduling diagnostic and/or surgical procedures, conducting interviews to explain hospital guidelines and policies, and obtaining complete clinical, demographic, and financial information. They will provide patients with preparation and appointment instructions, follow guidelines for special requests, and coordinate communications with clinical areas. Finally, the scheduler will notify patients of physician orders, preauthorization, and other financial clearance requirements, and perform 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

Nice To Haves

Prior medical experience and knowledge of insurance policies and procedures preferred
Medical terminology preferred
Demonstrated computer skills and related experience preferred

Responsibilities

Verifies insurance benefits
Processes accounts to ensure that patients are preregistered and required insurance authorization and precertification’s 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; pre-certifies inpatient admissions.
Works with financial counselor to request pre-payment and informs patients of discounts
Completes Medicare Questionnaire; 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 the patient requests
Notifies patient of physician order, preauthorization and other financial clearance requirements
Other duties as assigned