Administrative-Scheduler

Education:
Associate Degree in health care billing, accounting or business and a minimum of 1 year of health care healthcare scheduling and patient registration experience; OR High School Diploma/GED and a minimum of 3 years of health related experience in healthcare scheduling, billing, and registration.
Experience:
Experience must be in one of the following areas: health care scheduling billing, health insurance verification, ICD-10 coding, medical necessity checking, authorizations and copay collections.
Skills & Abilities:
Excellent word processing and computer typing skills.
Demonstrated interpersonal and communication skills
Must pass a medical terminology assessment test with 80% or greater.
Must successfully complete analytical skills assessment test with 65% or greater.




General Purpose of Job:
The Pre-Service Scheduling Specialist's main objective is to accurately schedule and pre-register patients for Sparrow Health System and verify insurance authorization requirements are met. Responsibilities include: scheduling patient appointments, providing pre-registration, verification of insurance, obtaining insurance authorizations, collecting patient payments, providing estimates, entering ICD-10 codes and completing appropriate medical necessity checking. Understand modality specific protocols to safely schedule patients.




Essential Duties:
This job description is intended to cover the minimum essential duties assigned on a regular basis. Associates may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.
Interview patients and/or physician offices for the purpose of scheduling and pre-registration. Collect accurate demographic and financial information to assist with billing requirements.
Enter appropriate ICD-10 codes for registration and billing purposes at the point of scheduling and registration.
Transcribe verbal orders from physician (offices) with accurate medical information to schedule appropriate exams.
Provide patients with test prep instructions.
Verify orders are accurate and verify order meets payer and compliance requirements.
Verify medical necessity checks upon scheduling a patient.
Verify insurance eligibility and covered benefits.
Collect and verify necessary insurance authorizations.
Utilize appropriate resources to assist when scheduling stat, add-on, or unfamiliar procedure.
Timely responding to provider and patient requests for scheduling procedure.
Educate the patient as to their financial responsibility prior to the point of service.
Provide estimates for services as requested by the patient.
Collect pre-payment for hospital services that are not covered by the patient's insurance, including co-pays, deductibles, or prior patient balances.
Process accounts held internally or rejected by payers for errors related to registration, authorization and financial clearance activities.

Required Responsibilities of the Associate:
Demonstrates knowledge and maintains and respects patient right to privacy by following the HIPAA Privacy and Security policies and procedures.
Adheres to ICARE values and standards of behavior (Innovation, Compassion, Accountability, Respect, Excellence).
Role model behaviors that value the diversity of our associates, patients and customers and supports creating an environment that is inclusive, welcoming and respectful.
Communicates with patients, families and customers using AIDET (Acknowledge, Introduce, Duration, Explanation, Thank).
Works in a safe manner and promptly reports any hazards identified in the work environment or related to assigned responsibilities.