Role Summary:

This position is responsible for accurately performing the Schedule+® functions for physicians and patients, including but not limited to insurance verification and pre-certification for all scheduled services at an HCA Facility. Makes and receives phone calls with intent of scheduling services at an HCA facility. This position must demonstrate a commitment of quality customer service to patients, physicians, co-workers and the general public.

Role Responsibilities:

Insurance Authorization/Verification

• Thoroughly completes the insurance verification process to ensure the accuracy of insurance information.
• Obtains insurance authorizations, referral, and treatment consults as needed for all scheduled patients prior to receiving services.
• Coordinates peer-to-peer reviews as needed between the physician and the insurance company.
• Obtains benefit coverage from insurance companies and accurately enters information into the appropriate computer system.
• Obtains diagnosis information and/or CPT code from the physician/office or the outpatient department, as necessary for completing the insurance authorization process.
• Maintains proficiency in the various systems utilized during insurance verification and authorization process including various on-line payor eligibility programs.
• Monitors appropriate work lists to ensure timely insurance verification processing.
• Maintains documentation necessary for compliance with state, federal, and other regulatory agency requirements.
• Maintains proficiency in the various systems utilized during insurance verification and authorization process including various on-line payor eligibility programs.

Scheduling

• Makes outbound and receives inbound calls to schedule patients for imaging services at an HCA facility.
• Schedules and documents notes in hospital and Centauri’s operating system
• Provide patient prep instructions for the services scheduled
• Works with hospital staff to ensure patients are scheduled timely, appropriately and receive the upmost customer service

Clerical

• Monitors and manages the e-mail inbox or fax machine for assigned practices throughout the day.
• Works any requests e-mailed or faxes received
• Checks and responds to voicemails
• Creates, maintains and monitors log of patients and procedures scheduled for assigned physician practices.
• Monitors appropriate work lists to ensure timely insurance verification processing.

Additional Responsibilities:

• Effectively communicates operational activities and issues with co-workers, Supervisor, and Manager.
• Interfaces courteously and effectively with internal and external customers. Must consistently present a positive departmental and organizational image, as well as commitment to departmental goals, objectives, standards, policies and procedures.
• Demonstrates proficiency within assigned area of responsibility and a general understanding of the entire Patient Access process.
• Identifies and recommends process improvements for the Schedule+ Program.
• Performs other duties as assigned by the Patient Access Management Team.

Role Requirements:

• Excellent customer service or client relations experience; office or hospital environment
• Must be fluent in English and Spanish (read, write, speak)
• High volume call center experience preferred
• High school diploma or equivalent GED required
• Associates degree in a related field or a minimum of two years in patient scheduling, registration and/or healthcare billing
• Strong Literacy (grammar, spelling, math)
• Strong Microsoft Products, word, excel, outlook, windows