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 eligibility exceptions.

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

• Conduct essential introductory calls to patients pertaining to all assigned procedures.

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

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

• Independently re-verify eligibility and benefits upon identification of discrepancies prior to scheduling.

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

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

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

• Communicate the status of authorizations and timelines effectively.

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

• Finalize scheduling once all clearances are obtained.

• Identify potential escalations or patient fallout situations.

• Document all communications and escalate issues according to policy.

• Serve as the primary contact for initial patient fallout, including any hesitations or intent to cancel.

• Conduct first-level retention discussions to understand concerns, answer questions regarding insurance, costs, and processes, and offer education and reassurance.

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

• Uphold confidentiality and adhere to HIPAA rules and regulations.

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

• Complete mandatory training and in-services.

• Perform additional assigned duties as required.

⛳️ Requirements

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

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

• Previous experience making outbound calls using VOIP software.

• Exceptional written and verbal communication skills, with a strong emphasis 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 collaboratively within a team environment.

• Competence in following verbal and written instructions accurately.

• Flexibility to work a varied schedule.

• Patience and understanding in responding to stressful situations related to patient health and emergent conditions.

• Ability to multitask and prioritize effectively.

• High level of attention to detail.

• Strong organizational abilities.

• Problem-solving and reasoning skills.

• Capability to meet established quality standards.

• Professional demeanor and appearance.

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

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

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

• Strong commitment to delivering excellent customer service.

• Compliance with relevant organizational policies and regulations.

• High ethical standards and professionalism in conduct.

• Enthusiasm for continuously improving professional performance.

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

• Preferred: Certification in Medical Billing.

• Reliable transportation is required.

• Ability to work at any of the Company's locations as needed.

🏝️ 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, and Christmas Day.

• 401(k) with employer matching contributions.

• 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 available.

• Hospital Indemnity coverage.

• Eligibility for overtime in accordance with applicable laws.