JOB DESCRIPTION

Scheduling Manager

Department: Patient Access
Reports To: Patient Access Manager
Direct Reports: Workers’ Compensation Coordinators / Patient Appointment Schedulers
Employment Type: Full-Time | Exempt

Position Summary

The Scheduling Manager oversees the daily operations of the Patient Access scheduling function, with a primary focus on Workers’ Compensation (WC) coordination, patient appointment scheduling, referral management, and treatment authorization.

This role ensures efficient patient access, accurate claim documentation, timely authorization processing, and appropriate scheduling of injured workers with healthcare providers. The Scheduling Manager provides leadership, coaching, and operational guidance to the scheduling team while maintaining strong working relationships with employers, insurance carriers, third-party administrators (TPAs), and nurse case managers.

The position also collaborates closely with clinical teams, providers, surgical scheduling, and revenue cycle departments to streamline workflows, minimize scheduling delays, improve service quality, and support overall operational performance.

Key Responsibilities

1. Scheduling Operations and Workflow Management

• Oversee daily scheduling operations, including appointment coordination, referral intake, authorization tracking, and pending scheduling requests.
• Monitor scheduling queues, referral volumes, pending authorizations, and unscheduled appointments to ensure timely processing.
• Ensure injured workers are scheduled with the appropriate providers based on treatment requirements, availability, and carrier or employer instructions.
• Coordinate appointment availability and scheduling priorities with providers and clinic teams.
• Identify scheduling bottlenecks and implement process improvements to enhance patient access and operational efficiency.

2. Workers’ Compensation Coordination

• Oversee workers’ compensation claim intake, verification, and documentation.
• Ensure accurate recording of claim numbers, dates of injury, employer information, insurance carriers, adjuster details, and authorization requirements.
• Monitor treatment authorization requests and coordinate timely follow-ups with insurance adjusters, employers, and nurse case managers.
• Address authorization delays, denials, and compensability concerns that may affect patient treatment.
• Ensure work status reports, duty restrictions, and return-to-work documentation are distributed to the appropriate parties within established timelines.
• Maintain compliance with applicable workers’ compensation regulations, state-specific requirements, and payer guidelines.

3. Team Leadership and Performance Management

• Supervise, coach, and develop Workers’ Compensation Coordinators and Patient Appointment Schedulers.
• Provide onboarding, training, competency assessments, and ongoing performance feedback.
• Establish clear performance expectations and monitor individual and team productivity.
• Conduct regular quality reviews and identify opportunities for employee development.
• Manage staffing schedules, PTO planning, workload distribution, and queue coverage.
• Support recruitment, performance evaluations, and employee engagement initiatives.

4. Client and Stakeholder Relationship Management

• Serve as a primary operational contact for employers, insurance carriers, TPAs, and nurse case managers.
• Address escalated concerns involving scheduling errors, delayed authorizations, patient access, and service delivery.
• Build and maintain positive working relationships with external partners and referral sources.
• Participate in employer and carrier meetings, account onboarding, and operational reviews.
• Ensure timely and professional communication with internal and external stakeholders.

5. Quality Assurance and Operational Reporting

• Monitor key performance indicators, including scheduling turnaround time, referral-to-appointment conversion, authorization turnaround, call responsiveness, documentation accuracy, and team productivity.
• Conduct regular audits of claim documentation, authorization records, and scheduling activities.
• Identify recurring issues, conduct root cause analysis, and implement corrective actions.
• Prepare and present operational reports, productivity updates, and performance dashboards to leadership.
• Develop and maintain standard operating procedures, workflow documentation, and team reference materials.

6. Cross-Functional Collaboration and Compliance

• Work closely with Patient Access leadership, providers, clinical teams, therapy departments, surgical scheduling, and revenue cycle.
• Coordinate provider availability, appointment capacity, and scheduling priorities.
• Partner with billing and revenue cycle teams to ensure accurate payer identification, authorization, and billing information.
• Ensure compliance with HIPAA, patient privacy requirements, organizational policies, and applicable workers’ compensation regulations.
• Perform other duties as assigned by management.

Qualifications

Education and Experience

• High school diploma or GED required.
• Associate's or Bachelor's degree in Healthcare Administration, Business Administration, or a related field preferred.
• At least 3–5 years of experience in workers’ compensation coordination, patient access, medical scheduling, referral coordination, authorization, or healthcare operations.
• Direct Workers’ Compensation experience is required.
• At least 1 year of supervisory, team lead, or people management experience preferred.
• Experience in orthopedic practices, occupational medicine, or outpatient healthcare operations is strongly preferred.
• Experience working with insurance carriers, third-party administrators, employers, and nurse case managers is an advantage.

Technical Knowledge

• Working knowledge of workers’ compensation claim processing, authorization requirements, and scheduling procedures.
• Familiarity with medical terminology, orthopedic specialties, and healthcare administrative workflows.
• Experience using EMR or practice management systems such as Epic, Athenahealth, or similar platforms.
• Knowledge of insurance verification, referral management, payer requirements, and authorization processes.
• Proficiency in Microsoft Office applications, reporting tools, and payer or carrier portals.

Skills and Competencies

• Strong leadership, coaching, and team management capabilities.
• Excellent organizational, planning, and time management skills.
• Strong communication, interpersonal, and stakeholder management skills.
• Analytical skills with the ability to monitor KPIs and improve operational processes.
• High attention to detail and accuracy in handling patient, claim, and authorization information.
• Strong problem-solving, decision-making, and conflict-resolution skills.
• Ability to manage multiple priorities and work effectively in a fast-paced healthcare environment.
• Customer-focused mindset with a strong commitment to patient experience and service excellence.

Work Environment and Schedule

• Healthcare administrative and office-based work environment.
• Schedule flexibility may be required to support U.S. healthcare operations, including occasional evenings, early mornings, and weekends.
• May require coordination across multiple clinic locations and occasional travel to employer or referral partner sites.
• The role involves prolonged periods of computer use and frequent communication through phone, email, and other electronic platforms.