Scheduling & Auth Specialist 2. Children's hospital
Summary
Coordinates patient scheduling, insurance verification, and authorization processes using EPIC and medical coding systems to ensure timely care and accurate billing.
Job Summary: The Scheduling & Authorization Specialist 2 is responsible for managing end-to-end patient access and financial clearance processes, including check-in, registration, insurance verification, authorization review, and check-out activities. The role ensures accurate documentation in EPIC, reviews medical records for medical necessity, interfaces with payers to obtain and extend authorizations, and collaborates with the Patient Business Office (PBO) to support reimbursement, denials, and appeals. Serves as a liaison among physicians, outside medical groups, insurance carriers, patients, and internal departments to facilitate timely access to care, compliance with payer and regulatory requirements, and accurate, timely billing. Performs other duties as needed.
Education and Experience: Associate's Degree required. Minimum three years of related experience required. Minimum one year of healthcare experience preferred. Experience may be considered in lieu of degree.
Knowledge and Skills: Knowledge of various insurance types and their guidelines, including the ability to read and interpret EOB's. Working knowledge of current ICD and CPT coding systems. Able to keyboard 40 wpm. Able to read; write legibly; speak in English with professional quality; use computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operate/troubleshoot basic office equipment required for the position. Essential Interpersonal Skills: Able to relate and communicate positively, effectively, and professionally with others; work calmly and respond courteously when under pressure; collaborate and accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.
Licensures and Certifications: Medical coding certification preferred.