Scheduler/Authorization Coordinator

Summary: responsible for the coordination of the authorization/scheduling process, including but not limited to submitting clinical documentation, tracking approvals, initiating appeals for denials, and scheduling appointments.

Essential Duties and Responsibilities

• Submit, review, and process pre-authorization requests via insurance portals or phone.
• Collect and send necessary clinical documentation and medical necessity notes.
• Monitor the status of submitted requests and managing denials, including filling appeals.
• Acquire and verify insurance benefits and precertification as required by insurance.
• Obtain and review physician orders for scheduling of outpatient testing.
• Schedule required outpatient testing and procedures for Surgery, Cardiology, and other Outpatient procedures.
• Acquire medical necessity for all Medicare patients and perform net compliance for Medicare patients to adhere to Medicare guidelines.
• Prepare up-front collection documentation and enter patient information into scheduling and registration system, including pre-registration, and insurance authorization documentation.
• Other duties as assigned.

****MMH is an equal opportunity employer****

Minimum Qualifications: High school diploma or GED required. Previous hospital, medical scheduling/billing office or collections, or prior authorization experience required.