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Procedural Scheduler

St. Joseph Heritage Healthcare (SJHH) is one of California's most respected medical groups. With over 3,000 employees and 75 locations throughout California, including, Northern California, Orange County, High Desert and Los Angeles County, SJHH has been continually recognized as a leader in quality, customer service and information technology. This kind of success is the result of team work, a commitment to excellence and a strong adherence to the organization's mission, vision and values.
St. Joseph Heritage Healthcare (SJHH) provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, St. Joseph Heritage Healthcare (SJHH) complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.Job Summary: Under the general supervision of the Medical Office Manager/Clinical Supervisor, this position is responsible for scheduling surgical procedures with St. Jude Medical Center, Outpatient Surgery Center, or other local hospitals as the need arises. Key responsibilities include preparing clinical data for submission of requests for prior authorization, maintaining appropriate logs, and documentation of authorizations status.
Essential Functions:
Obtains authorization for procedures on both HMO as well as Non-HMO care patients. Under the directions of the CMS department, is responsible for gathering additional clinical information needed to support medical necessity of requested service or surgical intervention. (40%)
Arranges surgical procedures/equipment, updates and publishes surgical schedules as needed. (30%)
Provides information to patients regarding required consent forms for surgical procedures and provides pre-operative directions. (5%)
Ensures appropriate pre-op testing is scheduled and completed. (5%)
Advises patients of approval/denial of authorization requests. (5%)
Prepares and forwards clinical data as required to Specialists/Consultants. (5%)
Maintains electronic logs of referral status per protocols of the medical office. (5%)
Answers telephones/voicemails and communicates messages to the appropriate person or returns calls within 24 hour. (5%)
Additional Responsibilities:
Attends committee meetings as required and brings/communicates required information to the
Physicians and medical office manager.
Performs all other duties as assigned.
Age-Related Competencies: Demonstrates age appropriate communication skills for the population served.
Information Management: Treats all information and data within the scope of the position with complete confidentiality and security. Maintains all practices to protect PHI and follow HIPAA guidelines.
Risk Management: Cooperates fully in all risk management activities and investigations.
Safety Requirements: Is knowledgeable of, observes and complies with Codes of Safe Practice, safety policies and emergency procedures.
Minimum Position Qualifications:
Education: High School diploma or equivalent required.
Experience: Requires one (1) year experience with medical terminology, coding, and medical charting
Computer Skills: Basic computer skills in a Windows operating environment including Microsoft Word and an e-mail system.
Knowledge / Skills / Abilities:
Ability to communicate clearly read and write English.
Knowledge of grammar, spelling, coding and medical terminology.
Proper telephone technique.
General knowledge of healthcare insurance benefits and terminology.
Preferred Position Qualifications:
Education: Completion of an accredited Medical Assistant training program at a vocational school or college highly desirable.
Experience: Prior work experience in referral authorizations and Surgical Scheduling.
License / Certification:
Medical Assistant certificate
Current BLS certificate
Computer Skills: EMR experience (IDX, Touchworks/Allscripts) a plus.
Environmental Conditions:
May be exposed to identified chemicals and contact with patients, public and staff
Able to function in an environment that includes crisis situations while exercising appropriate interpersonal and critical skills.
Physical Requirements:
Sitting for long periods of time.
Ability to view and type on computer screens for extended periods of time.
Bending, reaching, stooping, kneeling, pushing/pulling, grasping and lifting/carrying up to 15 lbs.

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