What are the responsibilities and job description for the Scheduling & Prior Authorization Coordinator - Infusion Therapy position at St. Luke's?
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JOB SUMMARY
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The Scheduling & Prior Authorization Coordinator, under the direction of the RNs, Clinical Supervisor and Operations Leader, is responsible for assisting providers in the care of patients by coordinating the patients' clinic and hospital appointments. The Scheduling & Prior Authorization Coordinator uses current technology to transcribe orders, maintain the integrity of the patient medical record, gathers/enters and credits patient charges, and schedules patient appointments. The Scheduling & Prior Authorization Coordinator responsible for verifying health insurance, obtaining benefits and meeting payer requirements to secure prior authorizations for medications. Verifying insurance coverage, resolving any issues with authorization and escalating complicated issues to appropriate manager/supervisor. The Scheduling Coordinator also answers patient telephone calls, assists in the coverage of various inner-office positions, delegates tasks to appropriate staff and assists staff in resolving scheduling issues. Participates in quality improvement tasks, coordinates daily functions, scheduling tasks and performs clerical duties as assigned.
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MINIMUM QUALIFICATIONS
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Education: High School graduate or equivalent.
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Experience: One (1) year experience as a HUC, OR one (1) year health care experience, finance, or related setting.
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Licensure/Certification/Registration: N/A
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PREFERRED QUALIFICATIONS
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Education: N/A
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Experience: HUC, Certified Medical Assistant. Training and/or experience in follow-up or collection technique, medical terminology, and medical records coding and/or managed care reimbursement. Experience with obtaining insurance benefit investigation and prior authorizations.
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Licensure/Certification/Registration: CHUC or CMA certification or licensed as an RN, LPN, Paramedic, EMT, RT, or other licensure recognized under CMS Meaningful Use standards. Registered Technician with Minnesota Board of Pharmacy.
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KNOWLEDGE, SKILLS AND ABILITIES
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Knowledge of medical terminology. Knowledge of basic communication skills, computerized office applications, customer relations principles, telephone answering, keyboard proficiency and organizational skills. Knowledge of quality improvement functions and processes. Ability to establish and maintain empathetic, respectful and positive customer relations behaviors and to effectively communicate with clinic Physicians, management and support staff, both on the telephone and in person. Ability to present and maintain a professional image and demeanor and to tactfully negotiate scheduling needs. Ability to prioritize, do multi-functional tasks and to complete tasks in a timely manner with close attention to details and accuracy, to work independently in an environment with interruptions. Ability to write legibly, see, hear, read, and speak English.
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READING - Intermediate: Ability to read and interpret documents such as operating and maintenance instructions
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WRITING - Intermediate: Ability to write routine reports, correspondence, or procedures.
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SPEAKING - Intermediate: Ability to effectively present information in one-on-one, small group situations or before groups of customers, clients, and other employees of the organization.
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MATHEMATICAL SKILLS - Basic Skills: Ability to add and subtract two-digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance.
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REASONING ABILITY - Intermediate Skills: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
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PHYSICAL DEMANDS AND ENVIRONMENT
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PHYSICAL DEMANDS
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Prolonged, extensive, considerable sitting. Able to walk, bend, reach, stoop, crouch, lift objects up to twenty-five (25) pounds in weight.
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Stand - Occasionally Under 1/3 (1-2.5 hours)
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Walk - Occasionally Under 1/3 (1-2.5 hours)
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Sit - Continuously Over 2/3 (5.5 – 8 hours)
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Use hands to finger, handle, or feel - Continuously Over 2/3 (5.5 – 8 hours)
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Reach with hands and arms - Occasionally Under 1/3 (1-2.5 hours)
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Stoop, Squat, Kneel, or Crouch - Occasionally Under 1/3 (1-2.5 hours)
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Bending-repetitive forward - Occasionally Under 1/3 (1-2.5 hours)
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Talk or hear - Continuously Over 2/3 (5.5 – 8 hours)
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LIFTING REQUIREMENTS-
Up to 10 pounds - Frequently 1/3 to 2/3 (2.5 – 5.5 hours)
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Up to 25 pounds - Occasionally Under 1/3 (1-2.5 hours)
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WORK ENVIRONMENT-
Typical Noise Level - Moderate noise (examples: business office with computers and printers, light traffic)
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WORKING CONDITIONS
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Works in a normal office environment in a Specialty Physician clinic setting. May be exposed to hazards from electrical and mechanical office equipment. Little or no exposure to unpleasant working conditions.
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