Centralized Scheduling Coordinator at HaysMed – Hays, Kansas

The Orthopedic Pre-Authorization and Centralized Scheduler is responsible for coordinating and scheduling inpatient and outpatient orthopedic procedures and appointments. This role ensures accurate entry of orders, verifies insurance, secures prior authorizations, and informs patients and providers of necessary pre-procedural requirements. The position plays a critical role in facilitating seamless care delivery, supporting insurance compliance, and ensuring an exceptional patient experience.

Qualifications:

Required:

High school diploma or equivalent

Minimum three (3) years of healthcare-related work experience

Preferred:

Associate’s or Bachelor’s degree in a health-related field

Responsibilities:

Communicate with patients regarding scheduling, authorizations, insurance statuses, and preparation requirements

Scheduling and Coordination:
*Schedule all orthopedic appointments, tests, surgical procedures, and pre-operative clearances
*Communicate appointment details and pre-procedure instructions to patients and provider offices
*Select appropriate surgical instruments and supplies in coordination with clinical teams
*Coordinate all specialty pre-op clearances (e.g., PAT, PCP, cardiology)

Order Management & Documentation:
*Enter electronic orders promptly and accurately
*Verifies written physician orders, documentation, and equipment needs
*Finalizes and ensures informed consent documentation is complete
* Confirms patient identification, demographics, symptoms, HIPAA forms, and insurance details

Prior Authorization Duties:
*Review medical documentation to determine medical necessity for treatments and procedures
*Submits accurate and complete prior authorization requests to insurance companies

*Maintains and tracks detailed insurance records for authorization status (approvals, appeals, and denials)

*Acts as a liaison between healthcare providers, billing department, authorization teams, and patients by maintaining active communication, resolving issues, following up on pending requests, handling denials, and informing patients of authorization statuses and explains any delays or denials as needed

*Prepares appeal documentation and schedules/support peer-to-peer insurance review processes
*Manages auto insurance claims related to orthopedic surgical procedures

Additional Duties:

*Manages all sports medicine injection scheduling and urgent MRI requests for the clinic.
*Prepares, initiates, and transmits referrals to external and internal providers for specialty consultations

*Prepares, initiates, and transmits ancillary studies such as EMGs.

*Active member of the Joint Quality Committee to support ongoing quality improvement efforts

Financial and Insurance Verification:
*Collect patient insurance information, co-pays/self-pay balances, and complete necessary registration fields to assist on-site registration teams
*Coordinate with Patient Accounts to confirm financial clearance, including for self-pay patients

Patient Interaction:
Frequency: Frequent

HIPAA Access:
This position requires access to Protected Health Information (PHI) in the following categories to perform essential duties:

Information Type Access Level
Patient Demographics (Name, DOB, Address, etc.) Primary
Clinical Information (Diagnoses, Test Results, Reports, etc.) Primary
Financial/Insurance (Billing, Payment, Plan Info, etc.) Primary
Coding Information (ICD, CPT, etc.) Primary