Surgery Scheduler/Insurance Authorization Specialist (FT) Job at PRMA Plastic Surgery
Position Summary: The Surgery Scheduler is responsible for scheduling all office procedures with doctors, patients and nurses. revisions, T/E, LAT flap, oncoplastic reductions, reductions, take backs, non-breast procedures, and cosmetics surgical procedures with doctors, patients, and hospitals for their assigned doctors. The Surgery Scheduler must be able to work closely with patients, hospitals, and physicians to coordinate pre-operative appointments and surgical dates. The Surgery Scheduler must obtain insurance benefits and pre-authorizations prior to scheduling any appointments.
Responsibilities:
- Schedule and reschedule, pre-operative, and surgical appointments for patients.
- Schedule and reschedule office procedures (including micropigmentation appointments) for patients which include scheduling patient’s with Terry Lively for Micropigmentation.
- Coordinate surgery scheduling with anesthesia, general surgeon, surgeon, co-surgeon, patient, and hospital.
- Obtain surgical pre-authorizations for all commercial payers
- Coordinate and monitor the physicians’ and nurses’ schedule for efficiency and flow. Reschedule patients when necessary to improve efficiency and flow due to surgery, clinic, and/or vacations.
- Verify patient benefits with insurance companies prior to any procedure being scheduled and/or performed.
- Prepare and mail pre-determination letters to include printing patient photos when necessary with supporting documentation to insurance companies, ensuring that copies are placed in patient files and scanned in the patient’s EMR chart. Prepare and mail appeal letters for predeterminations when necessary. Schedule Peer-to-Peer conferences as needed for office procedures and second stage surgeries.
- Update insurance referrals, pre-authorization numbers, anesthesia, procedure and surgery dates in the MOMS & Nextgen systems, patient chart and surgery-scheduling sheet when procedures are scheduled or rescheduled.
- Update surgeries and preoperative appointments in the Nextgen system to ensure all necessary information is notated to include insurance, authorization, procedures, anesthesia, equipment, and supplies.
- Obtain updated referrals for HMO patients prior to office procedures and verify referral is within authorized time period.
- Verify all CPT codes, ICD10 codes, and benefits for proposed procedure(s) are accurate andtask in the Nextgen system to the billing department in a timely fashion.
- Print weekly surgery listing and verify anesthesia. Make necessary changes in NextGen.
- Email nursing staff responsible for ordering OR supplies with implant, alloderm, and any other necessary intraoperative supplies
- Monitor the surgery schedule to ensure compliance with the appropriate hold anesthesiologists. Reschedule surgery cases to ensure compliance with appropriate hold anesthesiologists.
- Coordinate cosmetic surgery scheduling with anesthesia, surgeon, patient, and hospital back up.
- Coordinate LAT flap and T/E surgery scheduling with anesthesia, surgeon, patient, and hospital back up
- Complete surgery authorization list for Methodist Main, and North Central Baptist and Landmark weekly and fax to the appropriate parties every 2 weeks.
- Reporting weekly for location, office procedures, surgery pending authorizations
- Make a list of all patients to be called to move up (including reason) when there are open days to fill asap.
- Take and receive phone calls from nurse case managers and reviewers requesting additional information regarding cases.
Qualifications:
- Required - High School Diploma or GED.
- Required - 1-2 years scheduling experience.
- Preferred - 3-5 years’ experience.
- Preferred - Bilingual.
- Required - Knowledge of Microsoft applications.
- Required-Knowledge of insurance verification procedures.
- Preferred- knowledge of MOMS AT system and Nextgen system.
Please Note :
clarksqn.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, clarksqn.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.