Physician Surgery & Authorization Scheduler

ELKO COMMUNITY HEALTH CENTER LLC•Elko, NV

20h

About The Position

Convergence Health Elko is seeking a professional and detail-oriented Physician Surgery & Authorization Scheduler. In this role, you will cultivate relationships with physician offices, referral partners, hospitals, and ASC staff, while managing the end-to-end scheduling and insurance authorization process to provide patient-centric services to the patients we serve.

Requirements

High school diploma or equivalent required.
A minimum of three years’ experience working in a medical or dental office.
Strong project management and multi-tasking skills.
Proficient in MS Word, Excel, Outlook, and Electronic Medical Records (EMR) systems.
Ability to act with integrity, professionalism, and confidentiality.
Promotes positive work culture and teamwork.
Excellent communication skills; handles challenging situations and insurance appeals with diplomacy without compromising clarity.
Highly organized, skilled at prioritizing tight deadlines and urgent authorization timelines.
Able to work with high accuracy and meticulous attention to detail to prevent claim denials.
Drives ambassador-level service to patients, community partners, and cross-functional teams.
Demonstrates flexibility and supports changes that improve quality of care, service, and operations.
Takes initiative to assist other staff in completion of their assignments as needed.
Ability to work with confidential information and handle protected health information in a manner consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Nice To Haves

Experience with surgery scheduling and a strong working knowledge of medical insurance, CPT/ICD-10 coding, and the prior authorization process preferred.

Responsibilities

Schedules patients for hospital inpatient, outpatient, and ambulatory surgeries to ensure patients are scheduled in an appropriate and timely manner.
Obtains and manages prior authorizations, pre-certifications, and insurance verifications for all surgical procedures, ensuring approvals are secured from commercial and government payors prior to the date of surgery.
Interviews patients either in person or by phone to verify demographic and insurance details, and to ensure information is accurate prior to surgery.
Completes patient instruction forms and appropriate surgical area forms to ensure patients are provided with follow-up appointments, orders, and prescriptions.
Schedules patient’s pre-operative examination and lab work to ensure completion prior to surgery.
Collaborates with hospital and Ambulatory Surgery Center (ASC) surgery schedulers to enact efficient utilization of block times.
Notifies Surgery scheduling clerk to provide priority surgery time.
Notifies affected staff, services, and departments if a case is rescheduled, canceled, or added to ensure appropriate people are contacted.
Regular attendance is required to carry out the essential functions of the position.
Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge, and abilities to perform, within scope, role-specific functions.
Provides information and updates regarding patients’ surgery schedules and authorization status.
Assists patients with guidance on financial responsibility, insurance requirements, and filing necessary forms.
Takes reservations for surgeries and schedules dates based on the availability of the surgeon.
Orders patients' test results and assesses information from the report to determine if the patient is medically ready for surgery.
Assures appropriate coordination with other hospital departments when special surgical needs occur.
Files, collects, and organizes pre- and post-operational data, authorization documentation, and medical necessity chart notes for reference.
Schedules and manages authorizations for multiple surgeons across various specialties.
Other duties as assigned.