Patient Experience Representative-Scheduling Specialist

Intermountain Health

6d•$20 - $31•Onsite

About The Position

The Patient Experience Representative—Scheduling Specialist creates and manages provider surgery and hospital procedure schedules, including in-office procedures, equipment, schedule changes, cancellations, rescheduling, and clinical follow-up. The role uses provider power plans to ensure that required orders are proposed, signed off, and sent to the hospital. It obtains prior authorizations, verifies insurance eligibility and benefits, coordinates out-of-network referrals, and serves as a point of contact for authorization questions. The representative prepares required pre-surgical records and scheduling information, coordinates equipment and hospital supplies with providers, hospital staff, and surgical supply representatives, and calls in procedure orders to hospital schedulers before cases. The role meets with patients to explain the procedure and pre-operative requirements, escalates potential pre-operative health concerns, documents processes in patient charts, relays cost estimates, and investigates billing disputes.

Requirements

Two years of medical registration, billing, collection, scheduling, or insurance experience.
Two years of customer service experience.
Working knowledge of word processing, spreadsheet, email, and calendaring programs.

Nice To Haves

Associate's degree from an accredited institution; education is verified.
Two years at Intermountain Health as a PSR, MA, or in a similar position.
Two years of patient access experience, or two years of experience and extensive knowledge in the health insurance industry, including commercial insurance, Medicare, and Medicaid; health claims billing or third-party contracts.
EMR experience.
Spanish bilingual ability.
Knowledge of medical terminology.
Familiarity with CPT/ICD codes.

Responsibilities

Create and manage provider surgery and hospital procedure schedules, including in-office procedure schedules, changes, cancellations, rescheduling, and clinical follow-up.
Use provider power plans to ensure necessary orders are proposed, signed off, and sent for hospital orders.
Obtain surgery and hospital procedure authorizations by researching coverage and obtaining prior authorization; verify eligibility and benefits.
Coordinate referrals for patients going out of network and respond to surgery authorization questions.
Obtain the appropriate CPT code from the provider for authorization.
Propose iCentra requirements to create a pre-surgical FIN# and, where applicable, the surgical scheduling card used by the hospital scheduler.
Coordinate required surgical and procedure equipment, including items from hospital supplies and equipment brought by surgical supply representatives.
Coordinate necessary hospital items with hospital nursing staff and call in procedure orders to hospital schedulers the day before cases.
Meet with surgery and procedure patients to explain the process, including pre-op labs, tests, and other prerequisites.
Coordinate with providers and medical staff regarding pre-operative health concerns that may affect patient safety.
Scan and document processes in patient charts, relay cost estimates, and investigate surgery or procedure billing disputes.