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Patient Appointment and Authorization Specialist

2 months ago

Chattanooga, Tennessee, United States Siskin Children's Institute Full time
Job Overview

POSITION SUMMARY

The Patient Appointment and Authorization Specialist is essential in facilitating the effective organization of patient appointments and securing necessary authorizations for required services. This role demands exceptional organizational abilities, meticulous attention to detail, and a solid understanding of healthcare operations and insurance protocols to ensure a smooth patient journey and assist clinical teams.

PRIMARY DUTIES

Appointment Coordination:

  • Manage and schedule patient appointments, encompassing evaluations, follow-ups, tests, and required services.
  • Confirm patient details, insurance information, and any specific prerequisites before scheduling.
  • Relay appointment specifics to families and caregivers, ensuring they receive all necessary instructions and information.

Authorization Oversight:

  • Secure pre-authorizations and referrals for services.
  • Stay informed about insurance policies, coverage prerequisites, and authorization procedures.
  • Monitor and follow up on outstanding authorizations to guarantee prompt approval and reduce delays in patient care.

Patient Interaction:

  • Act as the main contact for families and caregivers regarding scheduling, authorizations, and insurance-related questions.
  • Provide clear and precise information to patients concerning appointment logistics, insurance coverage, and any necessary documentation.
  • Address and resolve patient inquiries or issues related to scheduling and authorizations.

Collaboration with Clinical Teams:

  • Work closely with clinical personnel to synchronize schedules and ensure an efficient workflow.
  • Communicate any modifications or updates in schedules and authorizations to relevant clinical staff.
  • Assist in preparing essential documentation and information for patient appointments and procedures.

Record Management:

  • Maintain accurate and organized records of patient appointments, authorizations, and communications.
  • Ensure all patient information is current in the electronic health record (EHR) system.
  • Generate reports on scheduling and authorization activities as needed by management.

Regulatory Compliance and Quality Control:

  • Ensure all scheduling and authorization processes adhere to organizational policies, insurance requirements, and regulatory standards.
  • Engage in quality control activities to identify and implement enhancements in scheduling and authorization processes.
  • Stay updated on changes in healthcare regulations, insurance policies, and best practices related to scheduling and authorizations.

Qualifications:

  • High school diploma or equivalent; an associate degree or certification in healthcare administration or a related field is preferred.
  • A minimum of 1 year of experience in healthcare scheduling, insurance authorization, or a similar administrative role.
  • Strong understanding of medical terminology, healthcare operations, and insurance processes.
  • Proficiency in utilizing electronic health record (EHR) systems and scheduling software.
  • Exceptional organizational, communication, and customer service skills.
  • Ability to multitask, prioritize workload, and operate effectively in a fast-paced environment.
  • Attention to detail and accuracy in managing patient information and authorization documentation.
  • Problem-solving abilities and the capacity to collaborate effectively with clinical and administrative teams.