Scheduling Specialist Lead

Job Summary

The Scheduling Specialist Lead is responsible for overseeing and optimizing the scheduling process for the organization, ensuring that resources, personnel, and equipment are allocated efficiently to meet operational demands. This position involves managing a team of scheduling specialists, coordinating complex schedules, resolving scheduling conflicts, and continuously improving scheduling systems and processes to ensure high levels of service delivery and operational efficiency.

Essential Functions

• Acts as a resource to Scheduling Specialists for all PAC guidelines, processes and applications.
• Trains new hires to department standards and processes. Assist with ongoing training and education of staff.
• Takes escalated calls and complaints from patients, family members, insurance companies or other entities.
• Assists with delegation of outbound call list and tracking.
• Schedules for Specialty and PCP practices and correctly handle complex rule sets across multiple Medical Groups and Markets.
• Maintains optimal productivity for call handling and wrap-up.
• Ensures and requests appropriate referrals and/or authorizations are present for specialty care. Maintain knowledge of insurance-specific referral and prior authorization requirements.
• Follows scheduling protocols and guidelines. Utilizes critical thinking to determine which processes to apply to specific situations.
• Determines calls with urgent needs and complete warm transfer to clinic staff.
• Researches patient requests in the medical record and provides information to patient or other entity.
• Monitors inboxes in EMR to ensure return communication from the clinic is handled promptly.
• Obtains information regarding refills, clinical questions, referrals, services, etc. Enter documentation and communication within EMR for non-urgent clinical calls.
• Collects insurance and pre-certification information from callers, validates insurance eligibility and correct PCP assignment.
  Attends educational sessions and department meetings as scheduled.
• Performs other duties as assigned.
• Complies with all policies and standards.

Qualifications

• H.S. Diploma or GED required
• Associate Degree in Business Administration, Operations Management, or a related field preferred
• 1-3 years of experience in scheduling, operations, or a healthcare setting required

Knowledge, Skills and Abilities

• Knowledge of Windows based system, word processing software, spreadsheet software, telephony platforms, clinical and non-clinical EMR, and ability to utilize multiple applications at once
• Excellent communication skills
• Customer service background
• Excellent date entry skills
• Ability to work well under pressure
• Willingness to exercise judgment and independence
• Ability to work independently and as a team