Utilization coordinator vs scheduler

Differences between utilization coordinator and scheduler duties and responsibilities

Utilization coordinator example responsibilities.

• Manage and coordinate authorization of denial letters and request for appeals with all levels of services.
• Manage and coordinate the workload of the release team members and are responsible for organizing and hosting all production release windows.
• Perform accurate verification of eligibility and benefits as well as advanced application of CPT, ICD-9 and ICD-10 codes.
• Assign accurate ICD-9 and CPT codes to request services for referral and authorization processing.
• Claim adjudication for assign HMO members.
• Provide orientation to pre-certification process for HMO, PPO, and POS members.
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Scheduler example responsibilities.

• Manage clinic visit schedules, rehabilitation conferences, medical exams, trial appearances, depositions, etc.
• Utilize knowledge of medical insurance including manage care, Medicare, Medicaid, liability and workman's compensation.
• Manage patient pre-op responsibilities, and generate all necessary paperwork.
• Schedule procedure, surgery f/u, register new patients, referrals, insurance, send nurse messages.
• Schedule patients for test and surgery procedures with and without anesthesia using the Surgi-Server computerize scheduling system.
• Schedule patients for radiology and nuclear medicine procedures, verify insurance benefits, and obtain prior authorizations for patient procedures.
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