Surgical Coordinator

The Surgical Coordinator is responsible for ensuring patient pre-authorizations/pre-certifications and medical records are in place. Essential Duties and Responsibilities

The essential functions include, but are not limited to the following:

• Prepare and submit clean claims to various insurance companies either electronically or by paper
• Answer questions from patients, clerical staff, and insurance companies
• -Identify and resolve patient billing complaints
• Processes referrals/authorizations using appropriate method provided by insurance companies.
• Acts as a liaison between insurance and healthcare providers to ensure required referrals have been processed correctly for medical specialty visits.
• Documents/updates records to ensure all parties have accurate information.
• Communicates with patients to ensure follow-through with referrals or other care related needs.
• Supports care team and patients in synchronizing care with specialist and diagnostics offices.
• Accurately charts all information in EHR/EMR.
• Functions as a resource for patients around workers compensation, insurance and referral issues, with an ability to perform electronic insurance verification.
• Schedules appointments, makes follow up calls and documents appointments; faxes referral information to physician offices and diagnostics centers.
• Answers phone calls, takes messages and responds to routine patient, physician and client inquiries. Schedules routine appointments, diagnostic testing, labs and referrals to various providers.
• Provides support and information to patients and providers to problem solve and manage complex administrative issues.
• Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
• Ensures that the records are processed within the department's service levels.
• Review accounts for possible assignment and make recommendations to the Billing Supervisor; prepare information for the collection agency
• Assistance in provider license renewal
• Perform various collection actions including contacting patients by phone; correct and resubmit claims to third party payers
• Process payments from insurance companies and prepare daily deposit
• Participate in educational activities and attend monthly staff meetings
• Maintain strictest confidentiality; adhere to all HIPAA guidelines and regulations
• Perform other work-related duties as assigned

Minimum Qualifications (Knowledge, Skills, and Abilities)

• High school diploma or GED preferred
• Knowledge of medical billing/collection practice
• Knowledge of business office procedures
• Knowledge of basic medical coding and third-party operating procedures and practices
• Ability to operate a computer, computer software, and basic office equipment
• Ability to operate a multi-line telephone system
• Skilled in answering a telephone in a pleasant and helpful manner
• Ability to read, understand, and follow oral and written instructions
• Ability to establish and maintain effective working relationships with patients, employees, and the public
• Must be well organized and detail-oriented

Physical Demands and Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.

While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers; handle or feel objects, tools, or controls. The employee is occasionally required to stand; walk; sit; and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, and the ability to adjust focus. The noise level in the work environment is usually low to moderate.

Note

This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an