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. Performs other duties as needed.
Education and Experience: Associate's Degree required. Minimum three years of related experience required. Minimum one year of healthcare experience preferred. Experience may be considered in lieu of degree.
Knowledge and Skills: 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. Essential Interpersonal Skills: Able to relate and communicate positively, effectively, and professionally with others; work calmly and respond courteously when under pressure; collaborate and accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.
Licensures and Certifications: Medical coding certification preferred.
Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness.
Loma Linda University Health’s story is one of hope. Our people strongly believe in the work of physical, mental, and spiritual healing. They are also committed to excellence, integrity, and teamwork. We are a faith-based academic medical center in Southern California’s Inland Empire, and since our establishment in 1905, we’ve been a local, regional, national, and international leader in education, clinical care, and research.
Our 18,000 talented healthcare team members work in our system’s six hospitals, providing whole-person, patient-focused care to more than 57,000 inpatients and over a million outpatients annually. Our passion is to bring hope to each patient and family who seeks our help during their most vulnerable moments in life.
U.S. News and World Report ranks Loma Linda University Medical Center as a Top Riverside/San Bernardino metro area hospital. LLU Children’s Hospital and LLU Medical Center — Murrieta are on the U.S. News list of Top Performing Hospitals for Maternity Care and the Newsweek list of Best Maternity Care Hospitals. Our Medical Center and Children’s Hospital nursing teams have also achieved the prestigious Magnet Status recognizing our strong commitment to nursing excellence.
Loma Linda University’s eight professional schools offer more than 100 academic programs designed to prepare thousands of skilled Christian healthcare workers for service in our local area and locations worldwide. Our graduates enter their careers with an intellectual curiosity and a strong foundation of the knowledge and skills needed for their chosen field. The Great Colleges to Work For program has named Loma Linda University as an outstanding place to work six of the last seven years, and has added the University to its Honor Roll of institutions three times.
