Surgery Scheduler Auth

• Schedules surgeries for patients and physicians. This includes but is not limited to, calling, faxing, contacting facilities, providing necessary scheduling information, ensuring special equipment, coordinating and confirming schedules.
• Assures all necessary requirements for surgery are met, including patient’s history, physical, and ancillary testing results to assure timely completion prior to procedure. Forwards to facility and/or physician as indicated.
• Provides general information and education regarding pre and post-operative care with patient and/or family members. Assesses when further education is needed and refers back to the nurse as indicated. Redirects patients back to specialists/providers and facilities where appropriate.
• Screens referrals and pre-certification requests for completeness, coverage, network affiliation and medical appropriateness.
• Collaborates with the manager and/or insurance company to review referrals and/or pre-certification, policies, practice guidelines, denials, patient noncompliance, medical necessity, physician issues and other managed care issues as needed.
• Directs surgeries to appropriate facility to allow for maximum reimbursement. Coordinates insurance issues with pre-registration and/or credit department when appropriate.
• Acts as a liaison with physicians, patients, patient care staff, families, vendors/providers and insurers regarding referrals and preauthorizations.

Licensure, Registration, and/or Certification Required:

• None Required.

Education Required:

• High School Graduate.

Experience Required:

• Typically requires 1 year of experience in scheduling.

Knowledge, Skills & Abilities Required:

• Ability to provide good customer service and multi-task on a regular basis.
• Knowledge of insurance coverage.
• Strong verbal, interpersonal, and written communication skills.
• Ability to pay close attention to detail in a fast-paced environment.
• Must have knowledge on how to navigate on the Internet.
• Proficient computer and keyboarding skills.
• Strong ability to prioritize work flow.

Physical Requirements and Working Conditions:

• Exposed to a normal office environment. May be exposed to high noise level.
• Must be able to sit majority of the workday.
• Must be able to lift up to 10 lbs. occasionally.
• Operates all equipment necessary to perform the job.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.