Central Scheduler

The Central Scheduler is responsible for coordinating and scheduling all diagnostic procedures for White River Health / WRMC in a high-volume, fast-paced call center environment. This role requires strong attention to detail, excellent customer service, and effective communication skills to assist patients, physicians, and radiology staff. Duties include verifying active insurance coverage, confirming complete physician orders, collecting applicable copayments, and ensuring accurate and efficient scheduling of services

Title: Central Referral Specialist 

Department: Central Referral Office 

Reporting Relationships: Pre-Service Unit Supervisor

Job Summary: Processes patient referrals via central referral management system (Athena). Handles all incoming referrals, organizes information, and facilitates the collection of missing information. Obtains authorizations as needed, coordinates scheduling with individual specialties, and monitors the status of all referrals. Directly communicates with clinic staff via telephone as needed to provide support and assistance in obtaining the medical, demographic information, as well as completing the preauthorization process. 

Job Duties: 

1. Works within the central referral management system (Athena) to receive and manage referrals 

2. Monitors the verification process for insurance coverage, pre-certification, prior authorizations, and medical records for all referrals. 

3. Accurately enters referral information into EMR and notified specialty practice staff of referrals awaiting scheduling. 

4. Provide customer service to address patient, hospital, and provider inquiries and complaints in a timely manner 

5. Fulfills all compliance responsibilities related to the position 

6. Closely communicate with Pre-Service Unit for outpatient radiology procedures to be scheduled in a timely manner 

7. Schedule simple outpatient radiology procedures to be done at White River Health within a limited capacity as needed. 

8. Works together with other team members to achieve department and hospitals customer service goals. 

9. Participates in orientation, training, and in-service including huddles. 

10. Performs other duties as assigned by supervision. 

Qualifications: 

1. Education: 

wHigh School Diploma or its equivalent 

2. Training and Experience: 

w Minimum of one-year job-related experience 

w Customer service experience 

w Microsoft Office (Excel, Word) 

3. Job Knowledge: 

w Knowledge of medical and insurance terminology 

w Knowledge of insurance requirements and guidelines for governmental and non-governmental carriers 

w In depth knowledge of HIPAA 

w Basic computer skills including Microsoft Office and virtual meeting apps 

Essentials: 

§ Must be able to report to work fit for duty and free of any adverse effects of illegal drugs, medical marijuana, prescription medication, and/or alcohol. 

§ Maintains confidentiality of all information related to patients, medical staff, employees, and any other appropriate information. 

§ Must be able to effectively communicate both orally and in writing with other individuals, which includes but not limited to the ability to spell correctly and use good grammar. 

§ Must be able to organize and manage multiple priorities. 

§ Must have strong customer service skills including excellent interpersonal communication and presentation skills 

§ Is a strong team player and show commitment to organizational values. 

§ Must be able to solve the problems in dependently or as part of a team. 

§ Performs all duties in an independent manner with minimal direct supervision. 

§ Supports management decisions and performs all duties in a manner which promotes team concept and reflects the mission and philosophy of White River Health. 

§ Cleans assigned cubicle and common area on own initiative, continually maintains a neat and organized work area. 

§ Attends 75% (9 out of 12) monthly unit meetings to stay informed of department and health system information. 

§ Dress in a professional manner in hospital approved dress code, wearing hospital identification badge. Complies with WRH dress code policy No. 20:10. 

§ Properly clocks in and out in Kronos. Complies with WRH personnel attendance policy No. 70:01. 

Physical Demands: Job responsibilities require a considerable amount of computer work. The individual will be required to work on dual monitors for 8 hours with an interval of 30 minutes (or 60 minutes) lunch break. The individual must be able to utilize a keyboard and mouse. The individual must also be able to communicate on the phone. The individual must be able to move about freely and independently.