Procedure Scheduling Representative II

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

📋 Description

• Conduct introductory and follow-up calls to patients regarding assigned procedures.

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

• Review eligibility and authorization findings, clarify any discrepancies, and address escalations.

• Independently verify eligibility and benefits when discrepancies are detected.

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

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

• Ensure mandatory patient calls are completed within service level agreements (SLA).

• Communicate the status of authorizations and expected timelines.

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

• Finalize scheduling once procedures receive clearance.

• Identify potential escalations or patient fallout situations.

• Document communications and escalate issues as per policy guidelines.

• Act as the primary contact for initial patient fallout cases.

• Conduct first-level retention discussions with patients who show hesitation or intent to cancel.

• Address inquiries concerning insurance, costs, and processes, providing education and reassurance.

• Coordinate the handoff of patients who choose not to proceed to the Office Manager, Vice President of Operations, or the appropriate clinical team member.

• Uphold confidentiality and comply with HIPAA regulations.

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

• Complete mandatory trainings and in-services.

• Carry out other assigned duties.

⛳️ Requirements

• Must be located remotely in Maryland or New Jersey.

• 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, with a strong focus on customer service.

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

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

• Competence in following both verbal and written instructions.

• Flexibility in work schedule is essential.

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

• Skill in multitasking and prioritizing duties.

• Exceptional attention to detail.

• Strong organizational abilities.

• Capability to problem-solve and apply reasoning skills.

• Ability to adhere to predefined quality standards.

• Maintain a professional attitude and appearance at all times.

• Familiarity with CPT and ICD-10 coding rules.

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

• Working knowledge of the healthcare field, including medical specialties and terminology.

• Strong commitment to providing excellent customer service.

• Compliance with applicable organizational policies and regulations.

• High ethical and professional standards of conduct.

• Commitment to continuous improvement of professional performance.

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

• Preferred: Medical Billing Certification.

• Reliable transportation is required.

• This position is non-exempt (hourly) and eligible for overtime pay; overtime is not guaranteed.

• Not eligible for bonuses, commissions, incentives, or shift differential pay.

🏝️ 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) with employer matching.

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

• 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 options.

• Hospital Indemnity insurance coverage.

• Eligible for overtime pay in accordance with applicable laws.

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