Description
Englewood Health, a leading healthcare system comprising Englewood Hospital and the Englewood Health Physician Network, is committed to delivering exceptional patient care across northern New Jersey. We are dedicated to fostering a supportive and inclusive work environment where every team member can bring their skills, creative ideas, positive approaches, and a commitment to excellence. Join our dynamic team and contribute to our mission of transforming the lives of the patients and communities we serve.
Job Summary:
TheAuthorization/Scheduler is responsible for coordinating all pre-service requirements for patients receiving infusion therapy. This includes obtaining insurance authorizations, verifying benefits, scheduling patient appointments, ensuring clinical documentation is accurate and complete, and collaborating with clinical and administrative teams to maintain efficient patient flow. The role ensures a smooth, timely, and compliant infusion scheduling process to support optimal patient care.
Key Responsibilities 1. Insurance Authorization & Benefits Verification-
Obtain prior authorizations for all infusion services, injectable medications, and related procedures.
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Verify patient insurance benefits, coverage limitations, deductibles, co-pays, and out-of-pocket responsibilities.
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Communicate authorization status promptly to clinical providers, patients, and internal teams.
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Track authorization expirations and ensure renewals are submitted proactively.
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Coordinate with payors for clinical documentation requests, peer reviews, and medical necessity inquiries.
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Schedule infusion appointments based on therapy protocols, chair availability, medication preparation time, and patient preference.
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Maintain and update the infusion schedule to optimize patient flow and resource utilization.
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Communicate scheduling changes, cancellations, or delays to patients and staff in a timely manner.
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Ensure appropriate time allocation based on treatment type, length, and complexity.
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Coordinate with pharmacy and nursing teams regarding medication readiness and patient needs.
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Upload and maintain accurate patient records, authorizations, orders, and referrals in the EHR/EMR system.
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Review infusion orders for completeness (diagnosis codes, drug regimen, provider signature, etc.).
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Maintain detailed logs of authorizations, denial resolutions, and pending requests.
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Ensure documentation complies with payor policies, regulatory standards, and internal procedures.
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Provide clear explanations to patients regarding their scheduling, coverage, and financial responsibilities.
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Address patient questions related to appointment logistics or insurance processes.
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Deliver high-quality customer service while maintaining professionalism and confidentiality.
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Partner with nursing, pharmacy, billing, and provider teams to streamline the infusion workflow.
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Coordinate with billing specialists on denials prevention, clean claims, and reimbursement optimization.
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Participate in department meetings, process improvement initiatives, and cross-training efforts.
Department: Englewood Hospital Imaging &Therapeutics at Fairlawn
Location: Fairlawn
Status: Full time
Shift: Days
Hours: 8am-4pm
Job Essentials:
- Verifies that pre-certification obtained by ordering physician are completed for the correct exam as well as authorized for the correct site.
Education Requirements:
- High School Graduate or GED required.
Englewood Health provides a minimum rate to comply with New Jersey Law. The rate of pay for each position will be determined based on a variety of factors including the candidate's relevant experience, qualifications, skills, etc. The minimum rate does not include bonuses/incentives, differential pay or other forms of compensation. In addition to the minimum rate, eligible employees may receive comprehensive benefits, including health insurance, retirement plans, paid time off, and other wellness resources.
Minimum rate: $18.00
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