Scheduling Specialist I

Job Description:

• Schedule and pre-register patients for outpatient radiology exams
• Electronically verify insurance eligibility and accurately identify and collect patient financial responsibility
• Handle complex scheduled events, including high dollar testing and associated studies with study-specific instructions
• Communicate with service delivery areas to maximize patient flow and customer service
• Analyze patient insurance, identify the correct insurance plan, select appropriate HIS insurance and plan options, and document insurance order
• Apply recurring visit processing according to protocol
• Verify patient information with third-party payers
• Collect and document insurance referrals in HIS
• Communicate with patients and physician offices regarding authorization and referral requirements
• Identify financial responsibility forms and obtain completed electronic forms as necessary
• Escalate accounts according to department Defer/Delay policy
• Screen outpatient visits for medical necessity and issue Advanced Beneficiary Notices as appropriate for Medicare primary outpatients
• Provide cost estimates and collect/document Medicare Secondary Payer Questionnaire information
• Screen self-pay and out-of-network patients using approved technology
• Provide follow-up information and referrals to Medicaid vendors or Financial Counselors
• Initiate payment plans, obtain payments, and explain applicable funding programs and payment plans
• Incorporate point-of-service collection processes into daily functions
• Perform other duties as assigned by the manager

Requirements:

• High School Diploma or equivalent
• Two (2) to Five (5) years experience in area of expertise such as scheduling, financial clearance, or patient access
• National certification in HFMA CRCR or NAHAM CHAA required within one (1) year of hire
• Proficient in the use of Patient Registration/Patient Accounting systems and related software systems
• Must be able to comply with Trinity Health policies and procedures
• Must be comfortable operating in a collaborative, shared leadership environment