Scheduler-Full Time-Days

Cape Fear Valley Health

1d•Onsite

About The Position

Obtains and/or verifies demographic, clinical, financial, and insurance information in the process of appointment making for patient tests and procedures, pre-registering and financial clearing for service delivery. Validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Additionally, the incumbent obtains and processes signed physician orders to ensure clinical documentation for care delivery. The incumbent conducts online insurance eligibility/benefit verification, pre-certification/authorization, referral clearance and financial education on designated cases. As appropriate, the incumbent notifies patient/guarantor and collects patient liabilities, and refers appropriate cases to resource counseling for follow-up and consultation.

Requirements

High school diploma or equivalent required
Medical terminology required within one year of employment
1 year insurance/clerical experience within a hospital or medical office setting preferred
Must pass pre-employment testing and post-training testing
Must have knowledge of insurance and collection of payments
Must have experience with Microsoft software
Must possess excellent verbal and written communication skills, customer service skills and problem-solving abilities
Must be multi-skilled with the ability to appropriately handle complexity and stress with the changing needs of the patients, families, visitors, and the Health System
Must be able to communicate orally, see, and hear to collect information
Must have dexterity to operate office equipment

Nice To Haves

College courses in Business or Health Care Administration and/or Computer Technology preferred

Responsibilities

Receive orders and schedule outpatient appointments for all modalities except biopsy and special procedures and all radiology outpatient facilities
Determines proper scheduling requirements and/or limitations according to requested tests/procedures and schedules resources (equipment, staff, room, etc.)
Coordinates add-on and same-day appointments as required
Ensures proper test sequencing with minimal patient delays, when multiple testing is required.
Performs insurance eligibility/benefit verification, utilizing a variety of mechanisms (EDI transactions, web access and by calling payers) and documenting information within the appropriate registration system; supporting with reference number.
Pre-registers the patient for upcoming visit(s).
Calls patient to remind of appointment date, time, location, and preparation for procedures following protocols; as well as informs the patient of their financial responsibility, answer questions and give directions.
Validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance.
Informs patient/guarantor of their liabilities and collects appropriate patient co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration.
Provides patient, family and physician office education during scheduling process to inform them of preparations needed for diagnostic testing and proper scheduling instructions
Sends and/or communicates appointment confirmation to referring office
Reconciles charge reports daily and communicates errors to staff
Other duties as assigned