Scheduling & Auth Specialist 2-HOPD
About The Position
The Scheduling & Auth Specialist 2 is responsible for financially clearing insurance verifications for all services and patient financial classifications, reviewing medical records, interfaces with payers to extend authorization for treatment, collaborates with Patient Business Office (PBO), assists with reimbursement and authorization according to contracts, and supports the denials and appeals process. Obtains pertinent documentation to support authorization requests. Serves as the liaison between PBO, Central Authorization, physicians, outside medical groups (OMG), various insurance carriers, patients, and all departments for office visits, in-patient, and out-patient services. The duties outlined in this Job Description will be an important part of our Hospital Outpatient Department strategy for the delivery of care that is consistent with our mission, vision, and values. This role is therefore accountable to the governance structure of the (Loma Linda University Medical Center) (Loma Linda University Children's Hospital). Performs other duties as needed.
Requirements
- Associate's Degree required
- Minimum three years of related experience required
- Knowledge of various insurance types and their guidelines, including the ability to read and interpret EOB's
- Working knowledge of current ICD and CPT coding systems
- Able to keyboard 40 wpm
- Able to read; write legibly; speak in English with professional quality
- Use computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint)
- Operate/troubleshoot basic office equipment required for the position
- Able to relate and communicate positively, effectively, and professionally with others
- Able to work calmly and respond courteously when under pressure
- Able to collaborate and accept direction
- Able to communicate effectively in English in person, in writing, and on the telephone
- Able to think critically
- Able to manage multiple assignments effectively
- Able to organize and prioritize workload
- Able to work well under pressure
- Able to problem solve
- Able to recall information with accuracy
- Able to pay close attention to detail
- Able to work independently with minimal supervision
- Able to distinguish colors as necessary
- Able to hear sufficiently for general conversation in person and on the telephone and identify and distinguish various sounds associated with the workplace
- Able to see adequately to read computer screens, and written documents necessary to the position
Nice To Haves
- Minimum one year of healthcare experience preferred
- Medical coding certification preferred
Responsibilities
- Financially clearing insurance verifications for all services and patient financial classifications
- Reviewing medical records
- Interfacing with payers to extend authorization for treatment
- Collaborating with Patient Business Office (PBO)
- Assisting with reimbursement and authorization according to contracts
- Supporting the denials and appeals process
- Obtaining pertinent documentation to support authorization requests
- Serving as the liaison between PBO, Central Authorization, physicians, outside medical groups (OMG), various insurance carriers, patients, and all departments for office visits, in-patient, and out-patient services
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
