Office Scheduler and Coordinator - Youngstown Women's Health - PRN

Mercy Health BSMH•Youngstown, OH

2d•Hybrid

About The Position

The Surgery Scheduler/Prior Authorization Coordinator is responsible for coordinating surgical procedures, obtaining required insurance authorizations, maintaining assigned electronic work queues, and providing front-desk coverage at multiple practice locations. This position serves as a key liaison among patients, providers, hospitals, insurance companies, and clinical staff to ensure timely scheduling, accurate documentation, and a positive patient experience.

Requirements

High school diploma or GED required.
Ability to work at and travel between multiple practice locations

Nice To Haves

Previous experience in medical scheduling, surgical scheduling, prior authorization, patient registration, or a medical-office setting preferred.
Experience using an electronic health record system, preferably Epic, is preferred.
Knowledge of medical terminology, insurance verification, prior-authorization requirements, and surgical scheduling processes preferred.

Responsibilities

Coordinate and schedule inpatient and outpatient surgical procedures.
Communicate with providers, patients, hospitals, and surgical facilities regarding available dates, times, and required documentation.
Provide patients with preoperative instructions, testing requirements, arrival information, and postoperative appointment details.
Verify that surgical orders, consent forms, medical clearances, laboratory testing, and other required documentation are completed.
Schedule postoperative appointments and communicate any changes promptly.
Maintain accurate surgical schedules and notify the appropriate departments of cancellations or rescheduled procedures.
Monitor pending surgeries and follow up on incomplete clinical or administrative requirements.
Verify patient insurance coverage and benefits for surgical procedures, diagnostic testing, medications, and other services as assigned.
Submit complete and accurate prior-authorization requests to insurance companies within required timeframes.
Obtain and document authorization numbers, effective dates, approved services, and insurance correspondence in the electronic medical record.
Track pending authorizations and follow up with insurance companies to prevent delays or cancellations.
Communicate authorization denials or barriers to providers and leadership.
Assist with appeals, peer-to-peer requests, and the submission of additional clinical documentation when necessary.
Inform patients of authorization status and potential financial responsibilities according to organizational guidelines.
Review and maintain assigned electronic health record work queues daily.
Address scheduling requests, referrals, authorization needs, registration errors, claim-related edits, and other assigned work queue items.
Ensure work queue items are completed accurately and within established turnaround times.
Route items requiring clinical review or leadership assistance to the appropriate team member.
Monitor outstanding items and follow through until resolution.
Maintain accurate documentation of all actions, communications, and outcomes.
Provide front-desk coverage at multiple practice locations based on operational needs.
Greet and check patients in and out in a courteous and professional manner.
Verify and update patient demographics, insurance information, consent forms, and required documents.
Collect copayments and outstanding balances according to organizational policies.
Schedule and confirm patient appointments.
Answer and route telephone calls, messages, and patient questions appropriately.
Scan and index documents into the electronic medical record.
Assist with referral coordination and medical-record requests.
Maintain patient confidentiality and provide excellent customer service at all locations.
Travel between assigned practice locations as required.
Work collaboratively with physicians, advanced practice providers, nursing staff, medical assistants, registration staff, hospital departments, and insurance representatives.
Maintain knowledge of insurance requirements, payer policies, scheduling procedures, and organizational workflows.
Protect patient information and comply with HIPAA, regulatory requirements, and organizational policies.
Participate in staff meetings, training, and process-improvement activities.
Perform other duties as assigned based on practice and departmental needs.