Summary
The Sleep Study Coordinator is responsible for coordinating all aspects of sleep study services, including patient scheduling, insurance verification, prior authorization acquisition, referral management, and communication with patients, providers, and sleep testing vendors. This role serves as a key liaison to ensure a seamless patient experience from referral through testing and follow-up care while maintaining compliance with payer requirements and organizational standards. The position travels between the Orange and Guilford locations weekly. Reliable transportation is required.
Sleep Study Coordination
- Coordinate and manage sleep study referrals from providers.
- Schedule in-lab and home sleep studies in a timely manner.
- Ensure all required documentation, clinical notes, and orders are obtained prior to scheduling.
- Monitor referral and testing work queues to ensure timely completion.
- Track sleep study status from referral through result completion.
- Coordinate follow-up appointments with providers after testing is completed.
- Communicate testing instructions and expectations to patients.
Insurance Verification & Authorization
- Verify patient insurance eligibility and benefits for sleep-related services.
- Obtain and maintain prior authorizations for sleep studies and related services.
- Submit clinical documentation required by insurance carriers.
- Monitor authorization status and ensure approvals are received prior to scheduled testing.
- Address authorization denials, appeals, and additional documentation requests.
- Maintain accurate documentation of insurance verification and authorization activity in the electronic medical record (EMR).
Patient Service & Communication
- Serve as the primary contact for patients regarding sleep study scheduling, preparation, and follow-up.
- Respond to patient inquiries promptly and professionally.
- Educate patients on testing procedures, insurance requirements, and next steps in care.
- Collaborate with providers, nursing staff, and ancillary departments to address patient concerns and barriers to care.
Administrative Responsibilities
- Maintain accurate patient records and scheduling information.
- Monitor and prioritize work queues to ensure timely patient access.
- Generate reports and track key performance indicators related to scheduling and authorization completion.
- Ensure all documentation meets organizational, payer, and regulatory requirements.
- Participate in quality improvement initiatives and workflow optimization efforts.
Skills and Knowledge
- EMR preferably EPIC experience required
- Associate degree in healthcare administration or related field.
- Experience in sleep medicine, pulmonary medicine, neurology, or specialty practice operations.
- Knowledge of payer requirements related to sleep testing services.
- Experience working with home sleep testing programs.
Education and Experience
- High school diploma or equivalent.
- Minimum of 2 years of healthcare administrative, scheduling, referral coordination, or insurance authorization experience.
- Experience with insurance verification and prior authorization processes.
- Knowledge of medical terminology and healthcare workflows.
- Proficiency with electronic medical records (EMR) systems and Microsoft Office applications.
- Strong organizational, communication, and customer service skills.
- Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
Valid driver's license and reliable transportation.