Scheduler - Ins. Verification Rep

The Scheduler – Ins Verification Rep isresponsible for pre-certifying, scheduling, and pre-registering all scheduledoutpatients for applicable departments. The representative provides telecommunication to and from departments and physicians’ offices.

Job Summary :

The Scheduler – Ins Verification Rep is responsible for pre-certifying, scheduling, and pre-registering all scheduled outpatients for applicable departments. The representative provides telecommunication to and from departments and physicians’ offices. Responsible for providing printed schedules to participating departments and prints reports for distribution as needed. Answers questions about testing from offices and patients or refers to appropriate resources. The representative will follow very specific protocols in scheduling, and the collection of financial information.

Functions and Duties :

• Schedules office and hospital based medical procedures, for patients with appropriate provider and time / location slot, utilizing appropriate scheduling tools.
• Schedules and preregisters approximately 20 patients per day.
• Completes pre-procedure phone calls and confirms appointment times with patients via telephone.
• Provides accurate, detailed information to patients regarding test preparations, time of patients scheduled arrival, and any other directional information needed; takes appropriate action in responding to questions from patients.
• Responsible for obtaining precertification and pre-authorization when required by Medicare, Medicaid and all third-party payers.
• Assists and acts a financial advocate for self-pay patients.
• Pre-Registers patients by verifying that patient's record is up to date and accurate. Makes appropriate changes in computer system.
• Enters confidential personal health information and financial information into computerized system with a high rate of accuracy.
• Collects payment from patients, applies payments and adjustments to patient accounts in the computer system, and reconciles daily cash reports.
• Ensures that the Medicare Secondary Payer Questionnaire is accurately completed with the responses provided by the patient and adjust Medicare payment sequence when necessary.
• Verifies insurance eligibility for each patient using system program and update the record to reflect any updated information or changes necessary. Document any and all discrepancies in the patient record that affects insurance.
• Confirm charity eligibility for all self-pay patients that meet hospital criteria and discuss the outcome with the patients.
• Interfaces with appropriate hospital staff to ensure a cohesive working relationship in providing patient care serves.
• Performs all other duties as assigned.

Minimum Qualifications :

Education

Experience

Certifications, Licenses, and Registrations

Skills and Abilities

Physical Demands :