Overview We are seeking a detail-oriented and proactive Scheduler/Prior Authorization Specialist to join our healthcare team. In this vital role, you will coordinate appointment scheduling and manage insurance prior authorization processes to ensure seamless patient care and compliance with health insurance policies. Your expertise will help optimize clinical workflows, facilitate timely approvals, and uphold the highest standards of confidentiality and accuracy. This position offers an exciting opportunity to contribute to a dynamic healthcare environment where efficiency and patient satisfaction are at the forefront. Duties Coordinate patient appointments by scheduling, rescheduling, and confirming visits using Electronic Health Records (EHR) systems and other scheduling tools Obtain prior authorization from insurance providers for medical procedures, tests, or treatments, ensuring all documentation complies with insurance requirements Verify patient insurance coverage and benefits through insurance portals and managed care systems before appointments or procedures Communicate effectively with healthcare providers, insurance companies, patients, and other stakeholders to facilitate authorization processes Review medical records, clinical notes, CPT (Current Procedural Terminology) codes, ICD-9/ICD-10 (International Classification of Diseases) codes, and medical billing information for accuracy and completeness Maintain strict adherence to HIPAA (Health Insurance Portability and Accountability Act) regulations to protect patient confidentiality and privacy Track authorization statuses, follow up on pending approvals, and document all interactions within EMR/EHR platforms for audit readiness Checking electronic fax for incoming orders and medical records. Skills Strong knowledge of health insurance policies, managed care processes, and prior authorization procedures Proficiency in medical coding including CPT coding, ICD-9/ICD-10 coding, and ICD coding standards Familiarity with Electronic Health Records (EHR) systems and Microsoft Office applications for documentation and communication Excellent customer service skills with the ability to communicate clearly with patients, providers, and insurance representatives Understanding of medical terminology, medical records management, and clinical confidentiality policies Ability to navigate insurance verification portals efficiently and manage multiple tasks in a fast-paced environment Knowledge of healthcare compliance standards such as HIPAA to ensure data security and privacy Join us in delivering exceptional healthcare support by streamlining appointment scheduling and prior authorization processes. Your dedication will directly impact patient care quality while advancing your career in a vibrant healthcare setting!

Expected hours:

40.0 per week

Benefits:

401(k) 401(k) matching Dental insurance Employee discount Health insurance Health savings account Life insurance Paid time off Vision insurance

Work Location:

In person