Scheduler/Insurance Specialist

1. Considers priorities and special needs when scheduling preoperative appointments and surgical procedures.

A. Schedules appointments and procedures according to policies on nursing and anesthesia staff availability, patient needs and physician's block time. Must accurately enter all patient demographic and procedure info.

B. Coordinates surgical preoperative appointment schedule with clinical preoperative activities.

C. Edits, adds to, and cancels procedures on schedule according to procedure and physician's time and staffing requirements. Identifies conflicts and adjusts schedule as needed.

D. Prepares surgery schedule for review by the Clinical Lead so that adjustments may be made as required.

2. Verifies Insurance Benefits for Patients and generates Pre-procedure Estimates to comply with the No Surprise Billing Act.

A. Navigates several different insurance portals and websites to verify patients can be treated at our facility.

B. Obtains prior authorizations and certifications to ensure specific procedures are approved by insurance and there are covered benefits.

C. Uses the information provided to generate Pre-Estimates on services at our facility to give to the patient and other Revenue Cycle team members.

• High school diploma required
• Experience in a fast-paced office required; experience in a surgical Facility preferred
• Must have above-average attention to detail, organization, and efficiency skills
• Requires excellent communication skills – verbal and written- and ability to use multiple computer programs at once to multi-task
• Must work well within a team setting
• Ability to sit for long periods and to perform desk and office activities.

Coordinates the scheduling of procedures, following Facility policy and standards, to meet the needs of the patient and physician. May perform responsibilities of pre-certifying insurance benefits and pre-estimating costs for upcoming procedures.