Procedure Scheduling Representative II

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

📋 Description

• Oversee intricate procedures, advanced ASC cases, initial escalations, and exceptions related to eligibility.

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

• Conduct necessary introductory calls to patients regarding assigned procedures, along with additional calls as required.

• Serve as the onshore representative for the offshore eligibility and pre-certification team.

• Examine eligibility and authorization outcomes, clarify any discrepancies, and address escalations.

• Independently verify eligibility and benefits when discrepancies are recognized.

• Provide support for eligibility confirmation in cases of payer conflicts, escalations, same-day procedures, emergency procedures, and Medicare add-on procedures.

• Communicate the status of authorizations and expected timelines.

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

• Finalize scheduling once procedures receive clearance.

• Identify potential escalations and patient fallout scenarios.

• Document communications and escalate issues according to established policies.

• Act as the primary contact for initial patient fallout, including hesitation or intent to cancel.

• Conduct first-level retention discussions, addressing insurance, cost, and process inquiries while providing education and reassurance.

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

• Uphold confidentiality and adhere to HIPAA regulations.

• Monitor and respond to work-related emails throughout the day.

• Complete mandatory trainings and in-services.

• Perform additional responsibilities 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 experience.

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

• Previous experience making outbound calls using VOIP software.

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

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

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

• Ability to follow both verbal and written directives.

• Flexibility to work various schedules.

• Patience and understanding during high-pressure situations related to patient health and emergencies.

• Ability to manage multiple tasks and prioritize effectively.

• Strong attention to detail.

• Excellent organizational skills.

• Proficient problem-solving and reasoning capabilities.

• Ability to adhere to established quality standards.

• Professional demeanor and appearance.

• Familiarity with CPT and ICD-10 coding regulations.

• Solid understanding of insurance policies and third-party payer regulations.

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

• Reliable transportation.

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

• Preferred: Medical Billing Certification.

🏝️ Benefits

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

• Seven 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 for individual and family plans.

• 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 per applicable laws.