HealthCareMatch Careers

Surgical Coordinator Orthopedics
1st shift
40 Hours
Monday-Friday
Day Kimball Medical Group Orthopedics
JOB SUMMARY:
Under the direction of the Medical Practice Manager, the Surgical Coordinator is a position that includes surgical coordination, obtaining required authorizations for orthopedic, surgical, procedural and diagnostic services, FMLA paperwork processing and customer service. The Surgical Coordinator is responsible for obtaining and verifying patient demographic information, insurance, and other information necessary to ensure that all booked medical procedures are appropriately scheduled according to established protocols.

ESSENTIAL RESPONSIBILITIES:

Responsible for collaborative interaction with patients, physicians, other staff members and management, patient satisfaction and accurate processing of surgical and office medical procedures

Plans and directs verification of patient insurance and data processing to ensure accurate patient billing

Books, coordinates and reschedules patient surgery, pre-op and post-op appointments.

Appropriately responds to patient inquiries via telephone for scheduled medical procedures

Schedules patients in a prompt, pleasant, and helpful manner. Verifies necessary logistical information in the medical record.

Obtains insurance benefit information and prior authorization as needed. Ensures payor is contracted and in-network with doctor's office and facility.

Maintains and updates current information on physicians' schedules impacted by surgical caseload.

Utilizing established protocols, appropriately schedules patients in the surgical suite or appropriate medical office whenever possible, at the patients' convenience for needed services

Obtains necessary authorizations for diagnostic, orthopedic devices and orthopedic services as mandated by insurance carriers

Assists in the processing of FMLA paperwork resulting from medical procedures

As assigned, assist with processing referral requests by physicians and patients within a timely manner and according to clinic procedure

Answers questions regarding patient appointments and testing

SKILLS AND ABILITIES:
Good physical and mental health and capable of working under pressure.
Ability to perform detailed assignments, work accurately, follow directions and assess priorities.
Accurate and timely processing of all administrative functions (>97% )
Ability to work calmly and effectively under stressful situations.
Ability to deal with the public in a courteous, efficient and empathetic manner.
Extensive knowledge of all insurances and demographic information which drives the revenue cycle.
Responsible for current and new regulatory requirements for state, federal, and commercial payors.
Excellent telephone skills as measured by random audits, and the absence or presence of patient complaints
Adherence to established attendance and tardiness policies
Demonstrated excellence in customer service
Must demonstrate the ability to interact with personnel of all levels within the organization and work within a multi-disciplinary team environment.
Demonstrate excellent interpersonal skills, customer orientation and an outgoing and pleasant demeanor

PHYSICAL DEMANDS:
Sedentary Work: Exerting up to ten pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, or pull, or otherwise move objects. Involves sitting most of the time but frequently involves walking or standing activities for brief to lengthy periods of time.

ENVIRONMENTAL CONDITIONS:
Inside: Protection from weather conditions but not necessarily from temperature changes. Activity level may be high and work stressful. Potential exposure to communicable diseases and hazardous substances.

LANGUAGE, MATHEMATICAL AND RESONING DEVELOPMENT:
Language
Reading: Read and understand instructions, safety rules, etc.

Writing: Write sentences using cursive style and proper punctuation, and employing adjectives and adverbs.

Speaking: Speak clearly and distinctly with appropriate pauses and emphasis, correct pronunciation, variations in word order, using present, perfect and future tenses.

Mathematical
Add, subtract, multiply and divide all units of measure. Perform the four operations with like common and decimal fractions. Compute ratio, rate, and percent. Draw and interpret bar graphs. Perform arithmetic operations involving all American monetary units.

Reasoning
Apply common sense understanding to carry out instructions furnished in written, oral or diagrammatic form. Deal with problems involving several concrete variables in or from standardized situations.

RELATIONSHIPS TO DATA, PEOPLE AND THINGS:
Data
Coordinating: Determining time, place and sequence of operations or action to be taken on the basis of analysis of data; executing determination of and/or reporting on events.

People
Serving: Attending to the needs, requests or the expressed or implicit wishes of people. Immediate response is involved.

Things
Manipulating: Using body members, tools or special devices to work, move, guide or place objects or materials. Involves some latitude for judgment with regard to precision attained and selecting appropriate tool, object or material, although this is readily manifest.

QUALIFICATIONS:
Education:
High school graduate or equivalent required..
College level courses preferred but not required.

Experience:
At least 4 years of relevant surgical coordination and customer related experience within a healthcare environment
Knowledge of Healthcare Insurance preferred.
Knowledge of medical terminology preferred.
Excellent customer service skills required.
Prior experience and demonstrated competence with patient or customer information systems.

JOB DUTIES/RESPONSIBILITIES:
Demonstrate behaviors consistent with the practice's mission, which is: To meet the health needs of our community through our core values of clinical quality, customer service, fiscal responsibility and local control.
Responsible for collaborative interaction with patients, physicians, other staff members and management, patient satisfaction and accurate processing of surgical and office medical procedures
Plans and directs verification of patient insurance and data processing to ensure accurate patient billing
Books, coordinates and reschedules patient surgery, pre-op and post-op appointments.
Appropriately responds to patient inquiries via telephone for scheduled medical procedures
Schedules patients in a prompt, pleasant, and helpful manner. Verifies necessary logistical information in the medical record
Obtains insurance benefit information and prior authorization as needed. Ensures payor is contracted and in-network with doctor's office and facility
Maintains and updates current information on physicians' schedules impacted by surgical caseload
Utilizing established protocols, appropriately schedules patients in the surgical suite or appropriate medical office whenever possible, at the patients' convenience for needed services
Obtains necessary authorizations for diagnostic, orthopedic devices and orthopedic services as mandated by insurance carriers
Assists in the processing of FMLA paperwork resulting from medical procedures
As assigned, assist with processing referral requests by physicians and patients within a timely manner and according to clinic procedure
Answers questions regarding patient appointments and testing
Wo Follow-up with all patients post-surgical consultation to assist them with the decision to schedule surgery
Must be able to maintain confidentiality in a professional manner.
Participate in continuous quality improvement activities.
Remain flexible in work schedule in order to provide the most effective and efficient support for the practice and Medical Group's mission.
Demonstrate ability to communicate and interact with staff and physicians.
Demonstrate knowledge of all practice and Medical Group policies relevant to the performance of their responsibilities.
Demonstrate knowledge and application of principles of fire safety, hazardous communication program, infection control, and general safety.
Demonstrate ability to communicate and interact with patients and customers of all ages.
Follows procedures for verification of patient demographics information including insurance verification prior to the patient visit for all medical and surgical procedures
Maintains a thorough knowledge of departmental policies and procedures to ensure maximum reimbursement to the Medical Group.
Maintains professional and cooperative relations with fellow employees, medical staff, physician office staff, and patients to ensure superior customer service.
As assigned, processes all prior authorization requests by physicians and patients within a timely manner and according to clinic procedure
Performs other duties as assigned
WORKERS' COMPENSATION SPECIALIST

JOB SUMMARY
For the Surgical Coordinator that also functions as the Workers' Compensation Specialist
The Workers' Compensation Specialist is a key position in the medical practice playing a critical multifaceted role with the management of workers' compensation services and claims.

ESSENTIAL RESPONSIBILITIES:

Point of contact for new workers' compensation
Obtain demographics
Workers' compensation carrier
Workers' Case ID and contact
Schedule patient for office visit once WC is verified
Liaison between the medical practice and WC representative/adjuster
Provide timely documentation to carrier to include but not limited to:
Office visit notes
Work restrictions
Obtain visit authorizations from carrier to provide services at the practice and ensure
Facilitate appropriate, provider identified referrals to specialists and obtain prior authorization from WC carrier
Obtain prior authorizations to include:
Surgeries
Imaging
DME
Other services as identified
Monitor and contact patient and adjusters to ensure compliance
Work closely with DKMG Central Billing Office to identify areas impacting payment and provide office based documentation as needed
Ensure proper closing of a Workers' Comp Case with the carrier/adjuster, medical office and patient