Procedure Scheduler

Valley Health Systems, Inc.•Huntington, WV

5h•$18 - $22

About The Position

The Procedure Scheduler coordinates surgical procedures among providers, hospitals, ambulatory surgery centers, other procedural facilities, and patients. The role manages procedure scheduling, insurance authorizations and precertifications, preoperative requirements, and communication about patient financial responsibility. The scheduler works with clinical, billing, and revenue cycle teams to support timely, accurate, and patient-centered care. The position maintains scheduling and authorization records in the EHR and approved tracking systems, monitors outstanding requirements and barriers, and escalates issues that may delay care. It also provides professional service to patients and other stakeholders, protects patient privacy, follows organizational policies and applicable regulations, and participates in training, audits, workflow reviews, and quality improvement activities.

Responsibilities

Coordinate surgical procedure scheduling with providers, hospitals, ambulatory surgery centers, and other procedural facilities.
Review surgical orders, posting forms, and supporting documentation for completeness and accuracy.
Enter and maintain procedure, facility, and communication information in the EHR.
Coordinate pre-admission testing, preoperative appointments, and other required scheduling activities.
Communicate procedure details, scheduling updates, cancellations, reschedules, and changes in surgical plans to patients, providers, staff, and external facilities.
Monitor scheduled procedures for missing documentation, pending authorizations, and other barriers to timely care.
Ensure scheduling workflows and pre-procedure requirements are completed and documented; escalate urgent concerns, unresolved barriers, or potential delays.
Determine payer authorization requirements, submit authorization and precertification requests with supporting clinical documentation, and follow up within established timeframes.
Maintain authorization records, including approval status, authorization numbers, approved services, and expiration dates; communicate approvals, denials, discrepancies, and outstanding requirements.
Coordinate authorization corrections to prevent avoidable delays, cancellations, denials, or reimbursement issues.
Submit retroactive authorization requests within payer deadlines, provide supporting documentation, follow up, communicate status, and escalate denied, delayed, or untimely requests.
Identify recurring authorization issues and recommend process improvements to reduce future retroactive requests.
Review insurance benefits and estimate patient financial responsibility, including deductibles, copayments, coinsurance, and other applicable obligations.
Communicate estimated financial responsibility, payment expectations, and available financial assistance resources to patients before procedures whenever possible; document discussions and refer patients to appropriate resources.
Coordinate with billing staff to resolve financial questions and escalate benefit discrepancies or billing concerns; do not guarantee coverage, determine final claim liability, or deny clinically necessary care solely because of estimated patient responsibility.
Maintain accurate, timely documentation in the EHR and approved tracking systems, and monitor work queues, reports, and tracking tools for outstanding requirements.
Document actions, changes, follow-ups, and resolutions; protect patient information and comply with HIPAA, organizational policies, and applicable regulations.
Participate in audits, workflow reviews, training, meetings, and continuous quality improvement activities.
Provide courteous, timely, and professional service to patients, providers, staff, insurance representatives, and external facilities.
Serve as a liaison among providers, patients, payers, surgical facilities, billing staff, and other departments; respond to inquiries and resolve routine concerns within the role’s scope.
Maintain compliance with company policies and procedures and perform other duties as assigned.