Senior Clinical Scheduler / Payor Administration

Our new and unique, first-of-a-kind, Center for Autism and Developmental Disorders is seeking to hire an experienced Clinical/Medical Scheduler with a minimum 5 years experience to support fast paced, and growing, multi-disciplinary clinical team of practitioners in an outpatient day treatment setting.  Knowledgeable of clinical practices, advanced patient scheduling, HIPAA, ABA clinical operations, Speech and Occupational therapy scheduling, Central Reach EMR platform, managing complex Excel spreadsheets and various components of insurance payor admnistration.  

Job Outline:

Clinical Scheduling

• Create weekly and monthly scheduling templates for all clinical providers
• Ensure all schedule are integrated into main EMR System
• Monitor employee time off requests and modify clinical schedules accordingly
• Monitor client drop off and pick up times in daily clinical schedule
• Ensure calendar dates in schedule are reserved and blocked for modifications to the clinical schedule
• Create and sustain clinical provider tables
• Track and ensure client cancellations are monitored and re-scheduled
• Act as primary liaison for communicating daily and weekly scheduling needs with client families in a professional and well-thought manner.
• Modify daily schedules for client and staff call out notifications including after hour cellular and email notifications
• Scheduling all tiers of clinical operations including training days, staff meetings and provider meetings
• Collaborate with medical billing and human resources departments on provider schedules and timesheet entries
• Work closely with Center Director and Executive Director to ensure mandates are met and weekly quota requirements.

Provider Credentialing and Onboarding

• Coordinate with Human Resources and Directors to assist with payor credentialing and onboarding paperwork and applications relating to the credentialing of providers in the Center to prevent delays.
• Provide daily communications and credentialing updates in an efficient and constructive manner to Administrative Resource Coordinator and Directors
• Maintaining weekly production reports on credentialing
• Maintain Master Roster Database of Payors and Payor Depts.

Client Authorizations

• Work closely with providers to obtain payor authorizations and tracking renewal authorizations.
• Coordinate evaluations and assessments with providers and client families for authorization renewals
• Verify assessment protocols are distributed to clients for authorizations and follow up to ensure receipt
• Obtain new authorization as required for new clients to be enrolled in the Center
• Provide daily updates with Center Director on all authorization activities
• Support claim collections and generate appeals for flagged claims
• Collaborate with Administrative Resource Coordinator/ Medical Billing team as needed

Administrative

• Monitoring phones for incoming calls regarding scheduling and cancellations.
• Monitoring phones for incoming calls from insurance payors regarding authorizations and provider credentialing
• Generating weekly reports
• Maintaining time off request records
• Scanning records as necessary
• Back up coverage to front office when needed
• Accept and process payments from clients
• Providing administrative support to Center Director as needed
• Other unusual needs that may arise to support clinical operations within the Center

POSITION QUALIFICATIONS

Competencies:

· Strong analytical and critical thinking skills to perform scheduling for three different disciplines

· Strong problem solving skills to support multiple factors to change at once.

· Strong organizational and electronic record keeping skills required

· Strong understanding of commercial insurance payors and the roles of the various departments within the commercial health insurance.

· Strong oral and soft communication skills required

· Strong professional business writing skills required

· Demonstrate ability to be flexible and adapt to change

· Demonstrate ability to work in fast-paced growing environment

· Maintain professional appearance at all times with staff and clientele

· Good customer service skills

· Punctual and dependable attendance

· Energetic and enthusiastic, and detail oriented

SKILLS & ABILITIES

Education: Bachelor’s Degree in health related field preferred

Experience: 5+ years of Administrative or intake experience in a medical or clinical services environment preferred

Technology Skills:

• Basic knowledge using PC, MAC, and IPAD technologies.
• Moderate knowledge of using EMR software, or similar clinical medical record system (Central Reach preferred)
• Basic knowledge of Google eSuite Platform: Drive, Calendar, Meetings, Etc.
• Basic knowledge of Microsoft Word, Excel & PowerPoint
• Basic knowledge of Office technologies, i.e: iCloud technology for record keeping and document storage uploads, fax, scanner, label makers, laminating machine, printers, walkie-talkies, etc.
• Basic knowledge of VoIP commercial office telephone system

Other Requirements:

· Minimum age of 21

· Applicants must be able to satisfactorily pass a background check, fingerprinting and drug test to complete the hiring process

PHYSICAL DEMANDS

Sedentary work. Exerting up to 20 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Repetitive motion. Substantial movements (motions) of the wrists, hands, and/or fingers. The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.