Scheduler-Full Time-Days

Facility

Hoke Hospital

Location

Raeford, North Carolina

Department

Centralized Scheduling

Job Family

Clerical

Work Shift

Days (United States of America)

Summary

Obtains and / or verifies demographic, clinical, financial, and insurance information in the process of appointment making for patient tests and procedures, pre-registering and financial clearing for service delivery. Validates medical necessity (LMRP / LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Additionally, the incumbent obtains and processes signed physician orders to ensure clinical documentation for care delivery. The incumbent conducts online insurance eligibility / benefit verification, pre-certification / authorization, referral clearance and financial education on designated cases. As appropriate, the incumbent notifies patient / guarantor and collects patient liabilities, and refers appropriate cases to resource counseling for follow-up and consultation.

Major Job Functions

The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time :

• Receive orders and schedule outpatient appointments for all modalities except biopsy and special procedures and all radiology outpatient facilities
• Determines proper scheduling requirements and / or limitations according to requested tests / procedures and schedules resources (equipment, staff, room, etc.)
• Coordinates add-on and same-day appointments as required
• Ensures proper test sequencing with minimal patient delays, when multiple testing is required.
• Performs insurance eligibility / benefit verification, utilizing a variety of mechanisms (EDI transactions, web access and by calling payers) and documenting information within the appropriate registration system; supporting with reference number.
• Pre-registers the patient for upcoming visit(s).
• Calls patient to remind of appointment date, time, location, and preparation for procedures following protocols; as well as informs the patient of their financial responsibility, answer questions and give directions.
• Validates medical necessity (LMRP / LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance.
• Informs patient / guarantor of their liabilities and collects appropriate patient co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration.
• Provides patient, family and physician office education during scheduling process to inform them of preparations needed for diagnostic testing and proper scheduling instructions
• Sends and / or communicates appointment confirmation to referring office
• Reconciles charge reports daily and communicates errors to staff
• Other duties as assigned

Minimum Qualifications

Education and Formal Training

Work Experience

Knowledge, Skills, and Abilities Required

Physical Requirements

Cape Fear Valley Health System is an Equal Opportunity Employer M / F / Disability / Veteran / Sexual Orientation / Gender Identity