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OICC Scheduler Coordinator

Scope/Impact:

Coordinates scheduling for all outpatient infusions at all locations, performs insurance prior authorization and insurance verification.

 

Job Functions – Prior Authorization / Referral Coordinator

  1. Have excellent familiarity and understanding of general medical terminology.
  2. Have excellent understanding of contact process for various insurance companies and processes required for completion of pre-authorizations.
  • Have excellent understanding of insurance plans and individual plan cards.
  1. Work closely with staff to ensure complete and accurate patient information, including patient demographic and current insurance information is correct.
  2. Assemble information concerning patient’s clinical background.
  3. Maintain ongoing tracking and appropriate documentation on prior authorizations via ARM to promote team awareness and communication between departments.
  • Contact review organizations and insurance companies to ensure prior approval requirements are met. Present necessary medical information such as but not limited to:  history, diagnosis, diagnostic and laboratory testing, while forwarding information as required.
  • Be the system navigator and point of contact for patients and families, with patients and families having direct access for asking questions and raising concerns. May assume advocate role on the patient’s behalf, with the carrier, to ensure approval of the necessary supplies/services for the patient in a timely fashion.
  1. Ensure scheduling and prior authorizations are processed in a timely manner.
  2. Contacts providers with authorization, denial, and appeals process information.
  1. Ensure pre-authorizations have been approved with the proper procedure code and diagnosis per physician order.
  2. Communicate with all campuses to ensure patient is scheduled at the nearest location.
  3. Maintains communication with clinic staff regarding requirements of individual specialists and insurance companies to assist with timely referrals.
  4. Uphold standards in adherence to department and facility policies.
  5. Other duties as assigned by direct supervisor.

 

“The essential job functions as stated are intended to describe the general nature and level of work being performed by individuals assigned to this job.  The stated job functions are not intended to be construed as an exhaustive list of all job responsibilities, duties and skills required of personnel so classified.”

 

License(s) / Certification(s) / Registration(s):

Required: None

Preferred:  Licensed Vocational Nurse (LVN)

 

 

 

Education:

Required: High School Diploma or equivalent.

Preferred: Associate degree in health care-related field

 

Amount and Type of Experience:

Required:

  • Ability to type using keyboard at least 30 wpm
  • Strong computer skills and knowledge of Employee Health Records (EHR)
  • Must have excellent grammar, spelling, and punctuation skills
  • Excellent verbal and written communications
  • Be highly focused and adept at completing simultaneous multiple tasks in a fast-paced work environment

Preferred:

  • One (1) year experience working in a physician’s office or medical setting
  • Relationship management experience

 

Position Type

Job Location

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