Outpatient Surgery Rn Jobs in Riverside, CA (NOW HIRING)

POSITION SUMMARY

We are looking to hire an Outpatient Surgery Scheduler for our vascular center. The Outpatient Surgery Scheduler is responsible for overseeing the full surgical scheduling lifecycle within our ambulatory surgery center. This role serves as the central coordinator between physicians, patients, clinical staff, and insurance carriers ensuring that every procedure is properly authorized, efficiently scheduled, and that the operating room schedule remains optimally utilized. The ideal candidate brings hands-on experience navigating managed care environments including CalOptima, Medicare, commercial PPOs, and IPA payors.

KEY RESPONSIBILITIES

Scheduling & OR Management

• Manage the daily and future surgical schedule to maintain optimal OR utilization
• Coordinate procedure add-ons and same-day scheduling requests efficiently
• Proactively identify and fill schedule gaps to minimize downtime and revenue loss
• Communicate scheduling changes, cancellations, and updates to surgeons, anesthesia, and clinical staff
• Maintain accurate scheduling templates and block time in the scheduling system

Insurance Verification & Authorization

• Verify patient insurance eligibility and benefits prior to scheduling across all payer types: CalOptima, Medicare (Traditional and Advantage), commercial PPOs, and IPA contracts
• Submit prior authorization requests and track approval status through payer portals and phone follow-up
• Ensure all required authorizations are in place before the procedure date; escalate denials or delays as appropriate
• Interpret authorization requirements including CPT codes, ICD-10 diagnosis codes, and payer-specific criteria

Order & Documentation Management

• Collect and review physician orders, operative consents, H&P documentation, and pre-operative labs
• Confirm all required pre-operative documentation is complete and on file prior to the day of surgery
• Maintain accurate records in the EHR and scheduling systems
• Communicate missing documentation requirements to referring offices and physician practices

Patient Coordination & Communication

• Serve as the primary point of contact for patients regarding scheduling, pre-op instructions, and authorization requirements
• Confirm surgery appointments, pre-operative instructions, and arrival times with patients and caregivers
• Address patient questions related to insurance coverage, cost estimates, and day-of expectations
• Coordinate interpreter services, transportation needs, or other accommodations as necessary

Cancellation & Add-On Management

• Track and manage surgical cancellations; document reason codes and communicate to appropriate departments
• Actively backfill cancelled cases by maintaining a waitlist of ready-to-schedule patients
• Evaluate and process urgent and add-on surgical cases in coordination with the charge nurse and surgeon's office
• Follow established protocols for late cancellations and no-shows

QUALIFICATIONS

Education

• High school diploma or GED required
• Associate's or Bachelor's degree in Healthcare Administration or related field preferred
• Medical Assistant or billing/coding certification a plus

Experience

• 25 years of experience in surgical scheduling, medical scheduling, or a closely related role
• Direct experience in an outpatient surgery center, hospital OR scheduling department, or surgical specialty practice strongly preferred
• Demonstrated experience working with CalOptima, Medicare, PPO plans, and IPA payors
• Hands-on experience obtaining prior authorizations and verifying insurance eligibility
• Experience with vascular procedures a plus

Skills & Competencies

• Working knowledge of CPT and ICD-10 coding as it relates to surgical procedures and authorization requests
• Proficiency with surgical scheduling software, EHR systems, and payer portals
• Strong organizational skills with the ability to manage multiple priorities in a fast-paced environment
• Excellent verbal and written communication skills; professional and patient-centered approach
• Ability to work independently, take initiative, and problem-solve under pressure
• Team-oriented with a collaborative mindset across clinical and administrative functions
• Bilingual (English/Spanish) a plus

WORKING CONDITIONS

On-site position at the outpatient surgery center. Standard hours align with the surgical schedule and may occasionally require early start times based on OR volume. Frequent interaction with surgeons, clinical staff, patients, and insurance representatives.