Job Description

Job Description

Georgetown Community Hospital

Internal candidates will need to complete a Transfer Request form located in HR. Submission of this form does not guarantee transfer.

External candidates will need to complete the application and then access and complete the Healthcare Assessment Tool that will be emailed once the application is submitted. Failure to complete the Healthcare Assessment Tool will halt your process.

Job Description

The Surgery Scheduler will primarily be responsible for scheduling medical procedures for patients by coordinating all aspects of the scheduling cycle. This will initially include order intake via phone queue and fax as well as insurance benefit verification. Additionally, the position requires an ability to handle clinical assessment and insurance authorizations that are necessary preconditions for qualifying patients both medically and financially for final appointment confirmation. This position will also involve a basic understanding of insurance material such as claims, denial resolution, and appeals as needed. This position reflects a help desk approach to scheduling by actively responding to the general needs of the ordering physicians and their patients.

1. Requires excellence in customer service and telephone etiquette. Must be able to participate in receiving phone calls via a department telephone queue.

2. Uses clinical knowledge to receive orders for review and clarification when needed, including medical necessity checking for all Medicare patients.

3. Must show a basic facility with insurance benefits, coverage verification, network access, coordination of benefits (COB), payment calculation, and referral requirements.

4. Must be able to calculate total cost and payment options for each requested service and effectively communicate with patients about their options.

5. Must be able to integrate a variety of clinical data, assess, and conduct medical necessity reviews with appointed utilization review departments. This will include exchanging clinical information with registered nurses and physicians and negotiating the best possible outcome or alternative modality.

6. Communicates all exam prep information directly to the patient including directions and registration arrival times to the facility and ancillary departments.

7. Must show a strong attention to detail including an ability to transfer patient data in a reliable and consistent manner within regulatory guidelines.

8. This position will work interdepartmentally in providing critical support toward maximizing upfront collections and patient throughout while minimizing patient delays, rescheduling, and cancellations.

9. Must show an ability to work in a culturally diverse work environment and display a sensitive approach toward those with learning disabilities or other communication challenges.

Job Requirements

Minimum Education:

Associates Degree Preferred

High School Diploma or equivalent preferred

Required SkillsRequires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.

1. 2-4 years experience in a medical environment (hospital ancillarydepartment, doctors office, x-ray lab), preferably with additional exposure toa related field such as registration, claims and patient financial services, orother ancillary department experience, etc. A broad employment history in thesesettings will be most helpful.

2. This position requires a High school graduate or GED and 24 months ofrelevant experience. Additionally, an Associate or Bachelors degree or theequivalent combination of experience and training is preferred. Customerrelations experience is a plus.

3. Requires ademonstrated ability to evaluate a patients medical history via chart notes orother clinical source and accurately apply it to commercial insuranceutilization criteria.

Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran