Job summary
Coordinates surgical schedule for surgeons and their patients.Acquires authorizations for patient procedures and imaging as ordered by the Sharon surgical providers.
Job seniority: entry level
Responsibilities
• Obtains authorizations for procedures and diagnostic imaging as required by patients' insurance companies and as ordered by the providers.• Receives from providers all orders for imaging procedures and biopsies.• Verifies patient demographics and insurance information and eligibility.• Calls insurance company to request prior authorization in a timely and professional manner.• If unable to provide required clinical information, seeks the assistance of a clinical staff member.• Upon receipt of authorization, immediately communicates with the patient and rendering provider.• In the event of an authorization denial, communicates with provider so he/she may request a peer-to-peer communication with insurer.• Maintains a tracking database of authorizations/denials received.• Reviews all cases with surgeon(s) and patient(s) prior to scheduling with OR.• Schedules all OR cases in Cerner and notifies surgeon; ensures if office schedule is affected that all patients are rescheduled.• Explains the surgical scheduling process to patient and provides appropriate patient education materials.• Fills out all appropriate paperwork for OR scheduling and pre-surgical testing.• Develops and maintains familiarity with payer-specific coding and billing requirements.• Meets deadlines and timeframes for assigned projects and tasks.• Reviews all superbills and electronic encounters for accurate code assignment and sequencing; works closely with providers and clinical staff to ensure that all encounters and charges are captured appropriately.• Collects and files/scans into the medical record all documentation (operative notes, consult notes, dictations, labor & delivery records etc.) for which billings/claims are created.• Enters transactional comments and billing notes into practice management system to assure accurate account documentation and communication with Billing Department.• Strives for consistent creation of 'clean claims.'• End of day reconciliation of encounters, charges and payments.• Performs month-end reconciliation.• Demonstrates regard for the dignity and respect of all patients, family members, visitors, and staff.• Displays a caring and courteous attitude and represents the medical practice in a positive, professional manner.• Promotes and contributes positively to intra-departmental and inter-departmental relationships with no more than two complaints in a six-month period.• Maintains the confidentiality of employees and departmental information with no infractions.• Adheres to departmental/hospital dress codes as observed by manager and wears picture identification badge 100% of the time.• Demonstrates willingness to assist co-workers and/or to accept additional assignments as requested to support the department's efficiency as observed by the manager.• Responds to all managers requests for information and assists in a timely and courteous manner.• Maintain and Model Nuvance Health Values.• Demonstrates regular, reliable and predictable attendance.• Performs other duties as required.
Requirements
• Some manual skills / motor coord & finger dexterity• Little or no potential for occupational risk• Sedentary/light effort. May exert up to 10 lbs. force• Generally pleasant working conditions.
