Job Description

JOB TITLE Insurance Verification Specialist/Scheduler Full Time

GENERAL SUMMARY OF DUTIES Responsible for scheduling all surgery cases, verifying patient eligibility and benefits, verifying insurance prior authorizations, and providing patient estimates. He/She will liaise with multiple referring doctor’s offices and will be an integral part of our business office team and will be valued as a key member of our organization.

SUPERVISION RECEIVED Business Office Manager

ESSENTIAL FUNCTIONS

• Scheduling surgeries for the surgery center.
• Work with physician offices daily to ensure surgery center has all essential information to be prepared to perform procedures and verify and provide financial clearance prior to surgery.
• Select appropriate physician preference cards for facility staff to be prepared for procedure.
• Verify patient insurance eligibility and benefits and confirm procedure is a covered service under their insurance plan for the surgery center.
• Verify authorizations and pre-certifications and work with physician offices and insurance to obtain as needed.
• Calculate and provide estimated financial responsibility to patients prior to services.
• Provide back-up support for the front office and registration as needed.
• Perform other duties as assigned.

EDUCATION & EXPERIENCE

• High School Diploma or GED
• Minimum 1-2 years of experience scheduling appointments and/or surgeries, preferred
• Minimum 1-2 years of experience with medical insurance verification and authorizations for medical procedures, preferred

KNOWLEDGE

• Knowledge of clinic policies and procedures.
• Knowledge of managed care contracts and utilization.
• Knowledge of CPT & ICD-10 Codes
• Knowledge of Deductibles, Coinsurance, and Copays
• Knowledge of computer systems, programs and spreadsheet applications.
• Knowledge of medical terminology

SKILLS

• Skill in gathering and reporting scheduling and claim information.
• Skill in written and verbal communication and customer relations.
• Ability to multi-task, manage time effectively, and deliver results.
• Strict attention to detail.
• Intermediate computer skills and knowledge of Microsoft Office.
• Ability to work effectively with medical staff, physician offices, billing office, and external agencies.
• Ability to identify, analyze and solve problems.
• Ability to deal courteously and professionally with internal and external customers.
• Ability to provide excellent customer service to diverse population.

PHYSICAL/MENTAL DEMANDS Requires sitting and standing associated with a normal office environment.

ENVIRONMENTAL/WORKING CONDITIONS Normal busy office environment with much telephone work and computer work.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

Benefits:

• Comprehensive health, dental, and vision insurance
• Health Savings Account with an employer contribution
• Life Insurance
• PTO
• 401(k) retirement plan with a company match
• And more!

Equal Employment Opportunity & Work Force Diversity

Our organization is an equal opportunity employer and will not discriminate against any employee or applicant for employment based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, parental status, sexual orientation, veteran status, genetic testing results or any other consideration made unlawful by federal, state or local laws. This practice relates to all personnel matters such as compensation, benefits, training, promotions, transfers, layoffs, etc. Furthermore, our organization is committed to going beyond the legal requirements of equal employment opportunity to take positive actions which ensure diversity in the workplace and result in a multi-cultural organization.