Scheduling Specialist - Avera Cancer Institute PRN at Abarca Health

Sioux Falls, South Dakota, United States

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Not SpecifiedCompensation

Entry Level & New GradExperience Level

Part TimeJob Type

UnknownVisa

Healthcare, OncologyIndustries

Requirements

Knowledge of medical terminology
High School or GED Equivalent (preferred)
Associate's in medical secretarial school (preferred)
1-3 years experience as a scheduler, biller, or in a medical office (preferred)
Visual acuity adequate to perform position duties
Ability to communicate effectively with others, hear, understand, and distinguish speech and other sounds
Ability to work specified hours (Monday-Friday; varied shifts, no weekends)

Responsibilities

Scheduling appointments for new and existing patients, ensuring timely access to essential care
Coordinating comprehensive care scheduling including labs, infusion, imaging, procedures, surgeries, and telemedicine appointments
Facilitating referrals and collaborating with Avera’s network, including regional and rural facilities, to support continuity of care
Completing prior and pre-authorizations for patients' insurance companies
Working appeals for insurance coverage
Verifying benefits
Making referrals and scheduling pre-operative physicals
Reviewing surgery information with patients
Scheduling, maintaining, and disseminating an accurate surgery schedule, including acquisition, retention, and organization of documentation
Providing clerical services for the department as indicated
Obtaining information (including physician orders) from physician offices for scheduling tests, procedures, and admissions in an accurate, timely, and sequential manner
Facilitating coordination of a plan of care for patients with various departments throughout the hospital and clinics, including working with equipment vendors for surgical equipment needs
Coordinating care between facilities for utilization of telemedicine to ensure continuity of care if applicable
Communicating information to physicians, staff, families, etc., when directed and in an appropriate and professional manner
Assisting with the collection and maintenance of records as needed by Performance Improvement, Joint Commission accreditation, CARF certification, OSHA guidelines, or as required by law
Coordinating scheduling of specialized equipment based on procedures
Maintaining physician calendar, procedure schedule, and all coordinating orders for procedures

Skills

Appointment Scheduling

Patient Coordination

Insurance Verification

Prior Authorizations

Pre-Authorizations

Insurance Appeals

Referrals

Surgery Scheduling

Benefits Verification

Telemedicine Scheduling

Patient Documentation

Abarca Health

Pharmacy Benefit Management services provider

About Abarca Health

Abarca Health provides Pharmacy Benefit Management (PBM) services, focusing on flexible and user-friendly solutions for health plans, employers, and government programs like Medicare and Medicaid. Its main product, the Darwin platform, allows clients to quickly implement and modify benefit designs while ensuring compliance with regulations. Abarca Health manages over $5.3 billion in drug spend and processes 100 million prescription claims annually, offering additional services like home delivery for prescriptions. The company's goal is to deliver exceptional service and innovative solutions in the PBM market.

Aventura, FloridaHeadquarters

2005Year Founded

VENTURE_UNKNOWNCompany Stage

HealthcareIndustries

501-1,000Employees

Benefits

PTO

Parental leave

Work flexibility

Health insurance

Wellness stipend

401k

Tuition reimbursement

Leadership development programs

Risks

Increased competition from Amazon Pharmacy and Mark Cuban's Cost Plus Drug Company.

Growing focus on specialty drugs may require platform adaptation.

Shift towards price transparency could pressure Abarca's pricing models.

Differentiation

Abarca Health's Darwin platform is highly adaptable and user-friendly.

The company offers innovative programs like Triple S en Casa for home delivery.

Abarca Health ensures compliance with ever-changing healthcare regulations.

Upsides

Abarca transitioned two million members to Darwin in 18 months, showing operational efficiency.

Collaboration with Blue Shield of California boosts Abarca's reputation in the PBM sector.

Recognition as a top IT workplace attracts top talent, driving innovation.

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