Description
At NorthBay Health, the Surgery Scheduler functions as a member of the clinic patient care team. Performs duties and orchestrates complex logistics required to schedule patient tests, pre-op/post-op visits, and complex surgical procedures. Responsible for scheduling and coordinating all aspects of the surgical procedure, including patient preferences, maintains close communication with the Operating Room Scheduler, Same Day Center Staff and assures all payer requirements are met prior to scheduling the actual surgery.
Responsible to secure accurate patient demographics, authorizations and payer information in a timely manner to ensure patient care is not delayed. Verifies and documents eligibility and benefits for patient's specific payers. Ensures appropriate documentation is in the patient's Electronic Health Record (EHR). Schedules patient procedures as appropriate, and coordinates transfer of necessary records. Reviews and appropriately schedules department procedures utilizing department specific appointment protocols.
PRIMARY JOB DUTIES
Gathers, updates and verifies insurance/payer information and ensures accurate entry into the practice management system. Confirms authorization.
Verifies insurance type and eligibility for care.
Determines when authorization for services is required and ensures authorization is obtained prior to service date. Determines and documents need for signatures for conditions of registration and Medicare secondary payment screen.
Prioritizes procedure requests based on clinical need as indicated by the ordering provider, and the Medical Services Request Form (MSR).
Schedules complex pre and post-op appointments requiring strong knowledge of pre-admission requirements, procedures, department protocols and timing.
Contacts patients upon approval or denial of authorization. If denied, advises physician of outcome.
Provides the patient pertinent information regarding their surgery, dates and times for appointments, map of facility to easily find their destination(s).
Reviews and coordinates the surgeon's schedule to ensure efficiency for both their time and operating room time.
Coordinates resources to schedule surgeries for department surgeons.
Coordinate scheduling between department surgeon (including multi-disciplinary departments), vendors, materials management, OR venues & patients
Assures appropriate verifications and authorizations are completed prior to scheduling patients.
Collaborates extensively w/ OR scheduling to assure maximum utilization of block time in each OR venue.
Consistently demonstrates and promotes a sense of team within the immediate and extended work groups.
Establishes and maintains effective communication with physicians, co-workers and patients.
Participates in educational programs, staff meetings and in-service meetings.
Performs other job-related duties and responsibilities, as assigned.
Qualifications
Education: High school graduate or equivalent preferred. Graduate from an accredited Medical Assistant program preferred.
Licensure/Certification: Medical Assistant certified preferred.
Experience: Minimum three year's of experience in a clinic setting with experience and knowledge of health insurance/ benefit requirements required. One or more year's of experience working as a surgery scheduler in the specialty care setting.
Skills: Strong organizational and written/spoken communication skills essential. Ability to work independently on a variety of complex tasks, managing competing deadlines. In depth working knowledge of Windows and Microsoft Word. Knowledge of ICD-10 and CPT coding. Knowledge of medical terminology, procedures and insurance rules and regulations required. Skilled in accuracy and attention to detail. Ability to coordinate, schedule and track complex surgery scheduling and multiple patient appointments. Strong ability to multi-task; schedule appointments for several multi-disciplinary clinics. Demonstrates calmness in stressful situations.
Interpersonal Skills: Demonstrates NorthBay's values including nurturing care, own it, respect relationships, build trust, hardwire excellence
Standards of Performance: Demonstrate performance by adhering to established policies and procedures and exhibiting the defined characteristics associated with attendance and punctuality.
Physical Effort: Attendance is an essential function of the job. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Requires some walking; prolong hours of sitting and standing. Requires use of telephone, writing and computer keyboard six or more hours each day. Requires stooping, bending, reaching, twisting and squatting.
Hours of Work: Monday through Friday, variable hours dependent upon clinic operations and volume.
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