Scheduler/Authorization Coordinator
Massac Memorial Hospital, Metropolis, IL, United States
Scheduler/Authorization Coordinator
Summary:
responsible for the coordination of the authorization/scheduling process, including but not limited to submitting clinical documentation, tracking approvals, initiating appeals for denials, and scheduling appointments.
Essential Duties and Responsibilities
Submit, review, and process pre-authorization requests via insurance portals or phone.
Collect and send necessary clinical documentation and medical necessity notes.
Monitor the status of submitted requests and manage denials, including filling appeals.
Acquire and verify insurance benefits and precertification as required by insurance.
Obtain and review physician orders for scheduling of outpatient testing.
Schedule required outpatient testing and procedures for Surgery, Cardiology, and other Outpatient procedures.
Acquire medical necessity for all Medicare patients and perform net compliance for Medicare patients to adhere to Medicare guidelines.
Prepare up-front collection documentation and enter patient information into scheduling and registration system, including pre-registration and insurance authorization documentation.
Other duties as assigned.
MMH is an equal opportunity employer.
Minimum Qualifications
High school diploma or GED required. Previous hospital, medical scheduling/billing office or collections, or prior authorization experience required.
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Summary:
responsible for the coordination of the authorization/scheduling process, including but not limited to submitting clinical documentation, tracking approvals, initiating appeals for denials, and scheduling appointments.
Essential Duties and Responsibilities
Submit, review, and process pre-authorization requests via insurance portals or phone.
Collect and send necessary clinical documentation and medical necessity notes.
Monitor the status of submitted requests and manage denials, including filling appeals.
Acquire and verify insurance benefits and precertification as required by insurance.
Obtain and review physician orders for scheduling of outpatient testing.
Schedule required outpatient testing and procedures for Surgery, Cardiology, and other Outpatient procedures.
Acquire medical necessity for all Medicare patients and perform net compliance for Medicare patients to adhere to Medicare guidelines.
Prepare up-front collection documentation and enter patient information into scheduling and registration system, including pre-registration and insurance authorization documentation.
Other duties as assigned.
MMH is an equal opportunity employer.
Minimum Qualifications
High school diploma or GED required. Previous hospital, medical scheduling/billing office or collections, or prior authorization experience required.
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