Procedure Scheduling Representative II

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

📋 Description

• Initiate introductory calls to patients for all assigned procedures; the initial call is obligatory.

• Conduct additional patient calls as required based on professional judgment.

• Act as the onshore liaison for the offshore eligibility and pre-certification team.

• Review eligibility and authorization findings, clarify discrepancies, and assist in resolving escalations.

• Independently re-verify eligibility and benefits when discrepancies are detected.

• Provide eligibility confirmation support for discrepancies, payer conflicts, and escalations.

• Serve as a backup resource for same-day, emergency, and Medicare add-on procedures.

• Ensure mandatory calls are completed within SLA.

• Communicate authorization status and timelines effectively.

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

• Finalize scheduling once cleared.

• Identify potential escalations or patient fallout.

• Document all communications and escalate issues as per policy.

• Serve as the primary contact for initial patient fallout.

• Conduct first-level retention discussions to understand concerns, address insurance, cost, or process inquiries, and provide education and reassurance.

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

• Maintain confidentiality and adhere to HIPAA regulations.

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

• Complete mandatory trainings 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 an equivalent combination of education and/or experience.

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

• Previous experience making outbound calls using VOIP software.

• Excellent written and verbal communication skills, including outstanding customer service.

• Ability to establish and maintain effective working relationships with doctors, clinical staff, co-workers, and the public.

• Capability to work independently as well as collaboratively within a team.

• Ability to follow both verbal and written instructions.

• Willingness to work a flexible schedule.

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

• Proficient in multitasking and prioritizing tasks.

• Exceptional attention to detail.

• Strong organizational skills.

• Problem-solving and reasoning abilities.

• Ability to meet predefined quality standards.

• Professional demeanor and appearance.

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

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

• Familiarity with the healthcare sector and medical specialty, along with medical terminology.

• Strong commitment to providing excellent customer service.

• Compliance with relevant organizational policies and regulations.

• High ethical and professional standards of conduct.

• Desire to continuously enhance professional performance.

• Preferred: Two years’ experience with Electronic Medical Records (EMR).

• Preferred: Medical Billing Certification.

• Reliable transportation.

• Ability to work assignments at any of the Company’s locations.

🏝️ Benefits

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

• 7 paid holidays.

• 401(k) with employer match.

• Medical, dental, and vision benefits for single and family coverage.

• Short-Term Disability.

• Long-Term Disability.

• Basic Life/AD&D.

• Employee Assistance Program.

• Voluntary Life.

• Accident coverage.

• Critical Illness coverage.

• Hospital Indemnity.

• Overtime eligibility in compliance with applicable law.