Centralized Scheduling​/Pre-cert Specialist

Centralized Scheduling/Pre-cert Specialist Description

Job Title: Centralized Scheduling/Pre-cert Specialist

Supervised by: Director of Patient Financial Services

Job Summary: This position plays an integral role in ensuring the smooth operation of our Ancillary Services and maintaining high standards in patient care. As a Centralized Scheduling/Pre-cert Specialist, you will be responsible for coordinating and managing patient appointments and schedules efficiently, while interacting with patients, physicians, and other healthcare providers.

• Appointment Coordination:
  Effectively manage and coordinate patient appointments, ensuring that schedules are optimized to maximize resource utilization and minimize patient wait times.
• Patient and Provider Interaction:
  Act as a liaison between patients, physicians, and healthcare staff to schedule appointments, relay information, and handle any necessary changes.
• Insurance Verification and Authorizations:
  Verify patient insurance coverage using tools like Tru Bridge, Availity, phone calls, and payer portals. Obtain necessary prior authorizations for services, ensuring accuracy and compliance with insurance guidelines.
• Records Management:
  Maintain accurate and detailed records of patient appointments, including cancellations and rescheduling. Ensure that all relevant patient data is properly documented.
• Customer Service:
  Provide top-tier customer service by answering patient inquiries, addressing concerns, resolving scheduling conflicts, and accommodating urgent appointment requests.
• Department
  
  Collaboration:
  
  Work closely with other departments (Radiology, Respiratory, Billing, Admissions, Outside Clinics, Lab, and clinical and administrative teams) to ensure smooth coordination of patient care and services.
• Scheduling Software Proficiency:
  Utilize scheduling software to effectively manage appointments, update patient data, and keep track of scheduling needs. Update insurance information, names, addresses, and phone numbers as needed.
• HIPAA Compliance:
  Maintain the confidentiality of patient information at all times in accordance with HIPAA regulations. Ensure all data is handled securely and discreetly.
• Meeting Participation:
  Attend department meetings and training sessions to stay informed about new procedures, tools, and protocols relevant to your role.
• Phone and Communication Duties:
  Answer phone calls, manage inquiries from patients, insurance companies, and healthcare providers, and ensure accurate and efficient communication that supports patient care.
• Team Support:
  Contribute to team efforts by using spreadsheets and other tools to assist in communication and tracking of patient care.
• Additional Duties:
  Assist with any other tasks that support the team’s goal of delivering superior patient care, such as helping to schedule patients, upfront collections, no-show calls/rescheduling, reminder calls/texts, and Good Faith estimates.
• Other Duties as Assigned

• Adheres to dress code, appearance is neat, clean and professional.
• Completes annual education requirements.
• Maintains and ensures patient confidentiality at all times.
• Reports to work on time and as scheduled, completes work within designated time.
• Wears identification while on duty, uses computerized punch time system correctly.
• Attends Hospital in-service and educational opportunities.
• Represents the organization in a positive and professional manner.
• Complies with all organizational policies regarding ethical business practices.
• Works at maintaining a good rapport and a cooperative working relationship with physicians, departments and staff.
• Ensures compliance with policies and procedures regarding department operations, fire, safety and infection control.
• Communicates the mission, vision and core values of the hospital.
• Maintains regulatory requirement, including all state federal and CMS regulations.
• Teamwork:
  Work independently while also being an effective team player. Collaborate with other departments and adapt to changing situations. Dedication to excellence for our Organization, patients and the community we serve.

• High school diploma or…