Surgery Coordinator DHR Vein Institute

Surgery Coordinator - FT
- Days - DHR Vein Institute

US:

TX:

McAllen | RMF CLINIC | Full Time

Summary:

FLSA STATUS:
Exempt Non-Exempt

MISSION STATEMENT:

Our Mission is to improve the well-being of those we serve with a commitment to excellence: every patient, every encounter, every time.

VISION:

Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence.

POSITION SUMMARY:

This position will determine insurance eligibility, financial status and eligibility for registration by reviewing insurance information via phone or online verification, calling third party payers to obtain insurance benefits which include the effective dates of coverage, billing address, pre-existing condition clauses, in and out of network benefits and maximum coverage. Such duties include but are not limited to:
Meeting with the patient and explaining their surgery orders and pre-surgical testing needed, scheduling in-office and in-hospital procedures, making sure necessary authorizations have been obtained, data entry into the facility computer system and implementing/participating in the development of new diagnostic testing or programs.

POSITION EDUCATION/

QUALIFICATIONS:

• High School graduate or G.E.D. certificate preferred
• Completion of CNA program, Medical Office Specialist, or comparable program preferred

JOB KNOWLEDGE/

EXPERIENCE:

• Two (2) years continuous experience in a busy healthcare office with at least one (1) year insurance verification experience (required); previous surgical scheduling experience is preferred.
• Prefer previous physician office or hospital experience
• Must have Excel, Microsoft suite computer experience and must be able to learn department IS system
• Must have excellent customer service skills
• Medical Terminology, ICD Codes, CPT Codes, HCPCS codes, and Modifier knowledge preferred
• Able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly and spell correctly
• Requires reasoning ability and good independent judgment
• Requires working with frequent interruptions
• Must project a professional image
• Must be able to be sensitive to cultural and bilingual issues
• Excellent organizational skills are necessary
• Good written and verbal communication skills required
• Ability to read, write and speak English
• Good understanding of insurance benefits, surgical orders and medical terminology.
• Ability to communicate clearly and concisely with all levels of nursing, administration, patients and physicians

Responsibilities:

POSITION RESPONSIBILITIES:

• Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practices
• Schedule Surgeries, for both in-hospital and in-office procedures
• Obtaining Authorization or pre-cert as needed for the above
• Schedule, coordinate and monitor appointments of patients for pre-surgical diagnostic testing and registration
• Forwards a completed copy of schedule with applicable patient benefits to front desk staff and/or MD for collection of applicable deductible and co-pay amounts
• Confirms billing address, pre-existing conditions, in and out of network benefits and maximum coverage
• Reviews and confirms patient's financial information by obtaining the insurance carrier information, benefit information, policy number, group name, group number, and the effective date of coverage
• Ability to reference ICD-9-CM/ ICD-10-CM, CPT from doctor's order to insurance carrier for eligibility and coverage of procedure
• Reviews and confirms patient's deductibles, co-pays, and co-insurance with insurance carrier
• Ability to identify the appropriate coordination of benefits for insurance carriers
• Utilizes phone or on-line verification systems, i.e. TMHP, Availity, Data Link, internal system, etc., for insurance eligibility and benefits
• Determines financial status, meets with patient and refers patient for financial screening as appropriate
• Ensures referral/pre-authorization/pre-certification requirements have been met
• Reviews physician order for appropriate patient status (Inpatient/Outpatient) before verifying coverage for procedure
• Document clearly and concisely all patient benefit information on accounts through the computer system
• Screen and follow up on patient test results as required
• Has appropriate follow up and contact with hospital or patient if necessary
• When working at the reception desk, checking patients both in and out of the practice properly documenting registration in the computer, as needed
• Ensures patient confidentiality requirements are met in accordance with HIPAA/PHI policies and procedures
• Understand and adhere to managed care policies and procedures
• Perform inventory of supplies and equipment as necessary
• Answer and direct all phone calls appropriately
• Effectively communicates and works well with other team members
• Adheres to assigned…