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Patient Scheduling & Insurance Authorization Specialist

Urology Specialists

Sioux Falls, SD

Posted/Updated: 10 days ago

Job Description

Come join our growing team!  We have a rare full-time position open in our scheduling department at Urology Specialists!  We are looking for a detail oriented individual who is organized and ready to be a team player.  

Experience in the healthcare industry is preferred, but not required. 

This position is full-time, full benefit package eligible.  

Hours are flexible between 8am-5pm Monday-Thursday,  and 8am-4pm on Fridays.  No nights, weekends, holidays or on call are required, PLUS a half day off each week!  This position reports to the Director of Nursing and Clinical Operations.

Works with patients in person and via the telephone, and with local health systems, to accept 
outpatient diagnostic orders from physicians for hospital or surgical procedures; interprets 
physician request for diagnostic testing and schedules single to multiple tests according to 
required patient care protocols. Determines medical necessity validation and handles medical 
information along with transpiring medical orders into the electronic medical record. Takes 
direction from physicians, physician assistants and administration. .

The Insurance Authorization Specialist evaluates and performs all surgery, radiology and medication pre-authorizations prior to services performed and claim submission. Responsible for ensuring that the authorization matches the services performed. Communicates high deductible and denial information to the appropriate Billing staff. Reviews requests and forms for accuracy and completeness. Processes referral requests. Reviews patient demographics. Scans 
authorizations into the EMR system and documents communication appropriately. Serves as 
the primary contact for referring providers, insurance carriers, clinic and surgical staff and 
patients regarding pre-certification/pre-authorization. Other duties as assigned by direct 
supervisor.