Procedure Scheduling Representative II

This is a fully remote position, open to applicants in New Jersey, +1 more state.

📋 Description

• Oversee intricate procedures, high-end ASC cases, initial escalations, and exceptions in eligibility.

• Act as the senior operational point of contact among scheduling, eligibility, providers, and operations.

• Conduct introductory and mandatory calls to patients for designated procedures.

• Function as the primary onshore liaison to the offshore eligibility and pre-certification team.

• Review findings regarding eligibility and authorization while clarifying any discrepancies.

• Independently verify eligibility and benefits upon identifying discrepancies.

• Provide support for eligibility confirmation in cases of payer conflicts and escalations.

• Assist with same-day, emergency, and Medicare add-on procedures that require prompt validation.

• Complete mandatory patient calls within the Service Level Agreement (SLA).

• Communicate the status of authorizations and timelines.

• Explain out-of-pocket expenses and collect necessary deposits.

• Finalize scheduling once approvals are secured.

• Identify potential escalations or patient issues.

• Document communications and escalate issues in accordance with policy.

• Serve as the main contact for initial patient concerns, including hesitation or cancellation intent.

• Conduct first-level retention discussions, addressing questions about insurance, costs, and processes while providing education and reassurance.

• Coordinate transitions to the Office Manager, Vice President of Operations, or relevant clinical team when patients choose not to proceed.

• Maintain confidentiality and adhere to HIPAA regulations.

• Regularly check and respond to work emails throughout the day.

• Complete required training sessions and in-services.

• Perform additional duties as assigned.

⛳️ Requirements

• High School Diploma or equivalent, with a minimum of three (3) years of relevant experience; or a combination of education and experience deemed equivalent.

• Proficient in Internet and Microsoft Office applications (MS Word, MS Excel, MS PowerPoint, MS Outlook).

• Previous experience making outbound calls using VOIP software.

• Outstanding written and verbal communication skills, emphasizing exceptional customer service.

• Ability to build and maintain effective working relationships with physicians, clinical staff, colleagues, and the public.

• Capability to work independently as well as part of a team.

• Ability to follow both verbal and written instructions accurately.

• Flexibility in working hours and schedule.

• Ability to respond with patience and understanding during stressful situations related to patient health and emergencies.

• Proficient in multitasking and prioritizing tasks effectively.

• Exceptional attention to detail.

• Strong organizational abilities.

• Problem-solving and analytical skills.

• Ability to meet established quality benchmarks.

• Professional demeanor and appearance.

• Familiarity with CPT and ICD-10 coding standards.

• Solid understanding of insurance and third-party payer guidelines.

• Working knowledge of the healthcare sector and medical specialties.

• Understanding of medical terminology.

• Strong commitment to delivering excellent customer service.

• Compliance with relevant organizational policies and regulations.

• High ethical and professional standards of conduct.

• Desire for ongoing professional development and improvement.

• Preferred: Two (2) years of experience utilizing an Electronic Medical Record (EMR) system.

• Preferred: Medical Billing Certification.

• Reliable transportation.

🏝️ Benefits

• PTO: Up to 96 hours in the first year (pro-rated based on start date).

• 7 paid holidays: New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, the Day After Thanksgiving, and Christmas Day.

• 401(k) plan with employer matching.

• Medical insurance options (single and family).

• Dental insurance options (single and family).

• Vision insurance options (single and family).

• Short-Term Disability coverage.

• Long-Term Disability coverage.

• Basic Life/AD&D insurance.

• Employee Assistance Program.

• Voluntary Life insurance options.

• Accident insurance coverage.

• Critical Illness insurance coverage.

• Hospital Indemnity insurance coverage.

• Overtime eligibility in accordance with applicable laws.

• Reliable transportation and potential work assignments at any company location.