Central Scheduler

Position Summary

Under the leadership of the Director of Patient Registration, the Central Scheduler is an active member of the Patient Registration team that delivers patient registration services and support that is consistent with the strategic vision, goals, philosophy and direction of Patient Registration and CRHS. The Central Scheduler obtains accurate demographic, insurance, and physician information, and pre-registers inpatients and outpatients in a timely and accurate manner.

The scheduler relays patient clinical prep instructions and obtains prior authorizations from insurance carriers and notifies patient and physician of any denial of service. The scheduler receives the initial calls from doctors’ offices or patients to schedule appointments and enters the appointments into the scheduling system. The Central Scheduler verifies that medical necessity checks have been performed for Medicare patients.

• Education: Requires a high school diploma or a GED state certification.
• Experience: Requires up to one year of Patient Registration experience to become familiar with CRHS’s Outpatient and Emergency Department patient registration policies and procedures.
• Licensure, Registrations &
  
  Certifications:
  
  This job does not require a license, registration or certification.

• Receives incoming calls and schedules patients for services.
• Obtains orders from physicians.
• Enter appointments in the Community Wide Scheduler using Meditech.
• Contact patients’ and physicians’ offices to reschedule appointments when necessary.
• Verifies existing information to ensure the accuracy of data collected at the point of contact.
• Obtains and inputs any information not received on a previous visit.
• Relays patient clinical prep instructions.
• Verifies all insurance information and completes a financial worksheet.
• Determines if insurance plan requires prior authorization for requested service.
• Obtains requests for prior authorization and determines if service is covered by the patient’s insurance plan and if the provider requesting authorization is accepted by patient’s insurance company.
• Determines if requests for service meet prior authorization and/or medical criteria and requests additional information from provider as needed to make this determination.
• Explains the hospital's policy regarding payment at time of service and calculates estimated charges using the Schedule of Deposit as set forth by CRHS’s Up-front Policy.
• Refers all self-pay patients to the Financial Counselor for screening.
• Documents and logs authorization numbers, including number of visits and time span in Meditech and spreadsheet.
• Verifies Medicare’s medical necessity checks have been performed.
• Verifies insurance benefits obtaining co-pay and deductible amounts.
• Complies with all CRHS privacy policies and procedures including those implementing the HIPAA Privacy rule.
• Attends in-service training, education programs and meetings as required or directed.
• Adheres to established CRHS and departmental policies and procedures, objectives, quality assurance, safety, environmental, and infection control.
• Performs other related job duties as assigned.

Entry level

Full-time

Management and Manufacturing

Hospitals and Health Care