Scheduling Representative

Description:

The Scheduling Representative at Southeastern Gastroenterology Associates is responsible for the technical coordination of patient appointments and external diagnostic testing. This role requires applying clinical and medication knowledge to ensure scheduled services align with provider indications while verifying the accuracy of CPT and ICD-10 codes. Key operational duties include managing prior authorizations through payer portals, maintaining up-to-date insurance requirement files, and scheduling specialized imaging such as CT and MRI scans at outside facilities. Additionally, the representative serves as a primary point of contact for patients, providing detailed instructions for test preparations and arrival times, managing eCW "Jelly Beans," and facilitating external referrals to ensure continuity of care.

Responsibilities

• Effectively utilizes clinical knowledge when determining if the appointment is consistent with the diagnosis/ indications indicated by the provider.
• 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.
• Prioritize incoming authorization requests according to the urgency of patients.
• Confirms patient’s insurance provider and obtains prior authorization via payer website or by phone and follows up regularly on pending cases.
• Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations dating patient information/ keeping records.
• Confirm accuracy of CPT codes and ICD-10 diagnoses in the procedure order.
• Assist other members of the department as needed.
• Exhibit an ability to adapt to unpredictable situations within the work setting and has the ability to be flexible.
• Demonstrate excellent communication skills (verbal and written) as well as computer/ electronic medical records system skills.
• Completes Jelly Beans in eCW.
• Schedules and follows up on outside referrals to other practices.
• Schedule CT, MRI, and other testing at outside facilities.
• Other duties as assigned

Requirements:

Education and Qualifications

• High School Diploma required
• Insurance experience preferred

Job knowledge and skills

• Insurance verification and precertification
• Communicating procedure instructions to patient
• Familiar with ICD-10 and CPT codes
• General medication knowledge and their treatment use(s)
• Medical terminology
• Scheduling in outside facilities
• Excellent written and verbal communication skills

Compensation

Starting Hourly Pay: $17 per hour

Salary based on experience- Starting pay will be determined based on the candidate's relevant skills, qualifications, and experience.