Positions Location: Lansing, MI
General Purpose of Job:
The Pre-Service Scheduling Specialist's main objective is to accurately schedule and pre-register patients for Sparrow Health System and verify insurance authorization requirements are met. Responsibilities include: scheduling patient appointments, providing pre-registration, verification of insurance, obtaining insurance authorizations, collecting patient payments, providing estimates, entering ICD-10 codes and completing appropriate medical necessity checking. Understand modality specific protocols to safely schedule patients.
Essential Duties:
This job description is intended to cover the minimum essential duties assigned on a regular basis. Associates may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.
- Interview patients and/or physician offices for the purpose of scheduling and pre-registration. Collect accurate demographic and financial information to assist with billing requirements.
- Enter appropriate ICD-10 codes for registration and billing purposes at the point of scheduling and registration.
- Transcribe verbal orders from physician (offices) with accurate medical information to schedule appropriate exams.
- Provide patients with test prep instructions.
- Verify orders are accurate and verify order meets payer and compliance requirements.
- Verify medical necessity checks upon scheduling a patient.
- Verify insurance eligibility and covered benefits.
- Collect and verify necessary insurance authorizations.
- Utilize appropriate resources to assist when scheduling stat, add-on, or unfamiliar procedure.
- Timely responding to provider and patient requests for scheduling procedure.
- Educate the patient as to their financial responsibility prior to the point of service.
- Provide estimates for services as requested by the patient.
- Collect pre-payment for hospital services that are not covered by the patient’s insurance, including co-pays, deductibles, or prior patient balances.
- Process accounts held internally or rejected by payers for errors related to registration, authorization and financial clearance activities.
General Requirements
Patient Access or Revenue Cycle Certification - preferred.
Work Experience
• Experience must be in one of the following areas: health care scheduling billing, health insurance verification, ICD-10 coding, medical necessity checking, authorizations and copay collections. • Experience in customer service or call center - preferred.
Education
• Associate Degree in health care billing, accounting or business and a minimum of 1 year of health care healthcare scheduling and patient registration experience; OR High School Diploma/GED and a minimum of 3 years of health related experience in healthcare scheduling, billing, and registration. • Completion of Medical Terminology course - preferred.
Specialized Knowledge and Skills
xcellent word processing and computer typing skills. • Demonstrated interpersonal and communication skills • Must pass a medical terminology assessment test with 80% or greater. • Must successfully complete analytical skills assessment test with 65% or greater.
University of Michigan Health - Sparrow is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.