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 level escalations, and eligibility exceptions.

• Act as the senior operational liaison among scheduling, eligibility, providers, and operations.

• Carry out mandatory introductory calls with patients for all assigned procedures.

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

• Evaluate eligibility and authorization findings, clarify discrepancies, and resolve escalations.

• Re-confirm eligibility and benefits when discrepancies arise prior to scheduling.

• Assist in providing eligibility confirmation for payer conflicts, discrepancies, and escalations.

• Support same-day, emergency, and Medicare add-on procedures that require rapid validation.

• Complete patient calls within the service level agreement (SLA).

• Communicate authorization status and timelines effectively.

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

• Finalize scheduling once procedures have been cleared.

• Identify potential escalations or patient fallout.

• Document communications and escalate issues in accordance with company policy.

• Serve as the primary contact for initial patient fallout, including hesitation or cancellation intent.

• Conduct first-level retention conversations, addressing insurance, cost, process questions, and offering education and reassurance.

• Escalate cases and coordinate handoffs to the Office Manager, Vice President of Operations, or the appropriate clinical team member when patients choose not to proceed.

• Uphold confidentiality and adhere to HIPAA regulations.

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

• Complete all required training and in-service programs.

• Perform additional duties as assigned.

⛳️ Requirements

• High School Diploma or equivalent, with at least three (3) years of relevant experience; or an equivalent combination of education and experience.

• Proficiency 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, including exceptional customer service abilities.

• Skilled in establishing and maintaining effective working relationships with doctors, clinical staff, co-workers, and the public.

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

• Ability to follow both verbal and written instructions accurately.

• Flexibility to work a varied schedule.

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

• Proficient in multi-tasking and prioritizing tasks effectively.

• Exceptional attention to detail.

• Strong organizational skills.

• Adept problem-solving and reasoning abilities.

• Ability to meet established quality standards.

• Professional demeanor and appearance.

• Working knowledge of CPT and ICD-10 coding guidelines.

• Solid understanding of insurance knowledge and guidelines for third-party payers.

• Familiarity with the healthcare sector, medical specialties, and medical terminology.

• Strong commitment to delivering excellent customer service.

• Compliance with relevant organizational rules and regulations.

• High ethical and professional standards of conduct.

• Desire for continuous improvement in professional performance.

• Reliable transportation is essential.

• Preferred: Two (2) years of experience working with Electronic Medical Records (EMR).

• Preferred: Medical Billing Certification.

🏝️ 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, Day After Thanksgiving, Christmas Day.

• 401(k) plan with employer matching.

• Medical, dental, and vision insurance available for single and family coverage.

• Short-Term Disability coverage.

• Long-Term Disability coverage.

• Basic Life and Accidental Death & Dismemberment (AD&D) insurance.

• Employee Assistance Program.

• Voluntary Life insurance options.

• Accident insurance coverage.

• Critical Illness insurance coverage.

• Hospital Indemnity insurance coverage.

• Eligibility for overtime pay in accordance with applicable laws.