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Scheduler-Insurance Verification

Indian Trail, NC, United States
Job ID: 10453
Job Family: Clerical Support
Status: Full Time
Shift: Day
Shift Details: Regular
Department Name: 16041050936002-Ambulatory Services
Location: Union West - 6068 W Hwy 74

Overview

Job Summary

This position is responsible for the daily scheduling of patients into the Surgery Center. As such, a clear level of verbal articulation is needed, and an understanding of CPT and ICD-10 codes is imperative. Schedules are typically maintained in software, although manual schedules are sometimes required.



Essential Functions

  • Accepts calls for the scheduling of patients and accurately gathers the information required on patients. Secures proper patient identification and may gathering of various clinical documents such as history/physical, medical records, ancillary reports, etc.
  • Accurately researches, obtains and verifies the most current insurance information on the patient, which may include gathering all applicable addresses for claim submission concurrently understanding various state/federal regulations as related to medical guidelines.
  • Works closely with clinical staff to ensure the proper rooms, equipment and staff are available for the case in question.
  • Works with the appropriate insurance carrier to properly determine the patient’s insurance benefits. This enables them to accurately anticipate the patient’s amount due for the selected procedure.
  • Works with patients to explain payment policies and negotiates with the patient, or responsible party, a mutually acceptable resolution to the financial amounts owed.
  • Regularly facilitates calls to physician providers to acquire the service authorization number.
  • Understand commercial insurance payment methods and determine how implants are often reimbursed.
  • May train as a backup or assistant biller as needed. May also train on insurance follow up and/or collections as requested.

     

Physical Requirements
The ability to lift, carry or push/pull up to 20 pounds and, occasionally, lift carry, push/pull over 20 pounds. Standing, walking 30% of the time, and sitting 70% of the time. Eye/hand coordination, finger dexterity, color perception, functional visual ability and depth perception, functional sound perception and discrimination, functional verbal speech ability. Occasional bending, kneeling, climbing, twisting, reach at/or above and below shoulder level. Routine balancing as it pertains to normal office environment duties.



Education, Experience and Certifications

High school diploma required, Community College or trade school experience preferred.1-3 years experience in a medical office environment required, with some familiarity with diagnosis and procedures. Applicants must have demonstrable skills using computer, email, outlook, skype and other Microsoft office programs, especially Excel and Word. Applicants needs some medical terminology background or an ability and willingness to learn quickly. Excellent written and verbal skills, a high level of judgement and resourcefulness when dealing with both internal and external customers. Knowledge and/or experience with EMRs and/or physician practice scheduling software required. Ability to resolve conflict and read and understand insurance benefits and communicate those benefits to others. Ability to use basic math skills to generate balance estimates for surgery cases.