Mri Scheduling
1 month ago
Since 1972, Orlando Orthopaedic Center has remained independently owned and has grown to include 24 orthopaedic specialists across multiple subspecialties, many of whom are recognized leaders amongst their peers nationwide.
We have nine Orlando Orthopaedic Center locations throughout Central Florida, plus a state-of-the-art outpatient surgery center at the heart of our downtown campus located in the trendy SoDo Shopping District just south of downtown Orlando. To provide more immediate care, we have opened several orthopaedic injury walk-in clinics located throughout Orlando and the surrounding communities.
For over 50 years, our team of physicians and support staff have been getting Central Floridians back to work, back to play and back to making a difference in our community.
**POSITION**:Ancillary Services Coordinator
**REPORTS TO**:Ancillary Operations Supervisor
**JOB SUMMARY**:Responsible for reviewing orders, scheduling, verifying insurance and obtaining prior authorization for Ancillary Services, including Magnetic Resonance Imaging (MRI), Electromyography & Nerve Conduction Studies (EMG&NCS) and Therapy (PT/OT). Responsible for generating patient estimates and reviewing them with the patient as needed. Must follow scheduling, insurance, and documentation guidelines and maintain communication with Management and the Physician Teams.
**WORK HOURS**:Monday - Friday: 7:30am - 4:30pm or Monday - Friday: 8:30am - 5:30pm
**EDUCATIONAL REQUIREMENTS**:
- High school diploma, required
- Advanced degree, preferred
**QUALIFICATIONS AND EXPERIENCE**:
- Two years of work experience in a medical office or customer service position, required
- One year of experience performing insurance verification or prior authorization, preferred
- Knowledge of medical terminology and insurance carriers/benefits, preferred
- Knowledge of practice management and electronic health record software, preferred
- Ability to perform multiple and diverse tasks simultaneously
- Strong written and verbal communication skills
- Strong attention to detail and problem-solving skills
**Responsibilities include, but are not limited to, the following**:
**Scheduling**
- Review the orders list for orders set to the “Pending” or “OOC to Schedule” status and schedule patient for the ancillary service. Contact patients within the same business day as the order was placed.
- Review all order statuses which have a blank disposition. Either attempt to schedule the patient in house or document accordingly.
- Follow Ancillary Sheet or ancillary specific scheduling guidelines for correct scheduling steps and procedures.
- Advise patients of any special instructions to follow prior to their appointment.
- Answer all telephone calls in a polite and friendly manner, and by the third ring as often as possible; route call or take a message as needed.
**Pre-Certification**
- Verify insurance benefits via network portal or telephone as needed.
- Input insurance benefits information within the EHR.
- Update status of order based upon authorization status.
- Obtain authorization via network portals when applicable. When not applicable, phone in the authorization request or fax as needed.
- Review and provide clinical documentation which support medical necessity information to insurance carriers as needed for prior authorization.
- Ensure the authorization status is documented and current at all times.
- For insurance benefits and prior authorizations obtained over the phone, document call reference numbers and representative names. For requests initiated over a portal, document portal use and tracking ID or reference number provided, if applicable.
- When obtaining prior authorization for Worker’s Compensation patients, identify or create the correct insurance set for the claim (i.e., direct bill carrier versus third-party administrator).
- For denied Worker’s Compensation patients, call the patient to advise the order was denied and defer to their adjustor/nurse case manager or Patient Care Team for next steps.
- For denied commercial insurance patients, call the patient to advise the order was denied and defer to their Patient Care Team for next steps. Obtain the denial letter (if available) and send an EHR message to the ordering Patient Care Team advising of the denial reason, peer-to-peer phone number and instructions, and any applicable reference number or ID.
- For denied commercial insurance patients with orders that cannot be appealed, offer the option to be self-pay for the service.
- Create insurance sets as needed for Self-Pay services or Worker’s Compensation claims to be billed to a third-party administrator.
- Contact patients with pending prior authorization no later than 4 pm the prior business day to advise their appointment needs to be rescheduled to give more time for the authorization decision to be made.
- Follow up on pending authorizations within two business days from the initial authorization request to ensure
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