The Scheduling Representative obtains demographic, financial and insurance information in the process of appointment making for patient tests and procedures. Obtains minimal clinical information; up to and including diagnosis and procedures to create an appointment. Provides instructions to the patient on the test preparation and will print and mail patient itineraries if lead time is sufficient. Validates Medical Necessity (LMRP/LCD review) of Medicare and Non-Medicare cases for non-complex outpatient diagnostic testing to ensure financial clearance. Ensures billing compliance by obtaining and processing signed physician orders to ensure clinical documentation for care delivery.

ESSENTIAL FUNCTIONS

• Ensures patient safety by authenticating patient identity throughout all essential functions.

• Performs activities that relate to patient scheduling, documenting demographic and insurance information to identify and make appointment for correct patient; initiates the physician order verification process.

• Initiates Medical Necessity screening for non-complex diagnostic services according to Medicare and other payer guidelines. Familiar with and can access LMRP/LCD/NCD documentation. Disseminates the patient information, and support coverage of other intra-departmental functions. Contacts physicians/office staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s).

• Determines proper scheduling requirements and/or limitations for non-complex outpatient diagnostic testing. Per clinical unit protocol and instruction colleague utilizes correct equipment, room resource and staffing allocation for accuracy and to ensure a great customer experience.

MINIMUM QUALIFICATIONS

• High school diploma required. Associate’s Degree or an equivalent combination of education and experience preferred.

• Must possess a working knowledge of medical terminology, and data entry skills (50-60 keystrokes per minutes), as normally obtained through a high school diploma and/or associate degree or an equivalent combination of education and experience.

• Past work experience of at least (1) years within a physician office, hospital or clinic environment, performing patient scheduling. Experience surgery scheduling highly desired.