- Ensure that all surgeries are preauthorized and scheduled according to company guidelines, while meeting facility and safety requirements
- Empathetic and caring interactions with Guests
- Coordination with outside Providers, ancillary services and facilities for pre-operative clearance
- Coordinates and maintains physician OR and follow-up schedule
- Coordinates with physician, guest and facility when scheduling cases
- Manages OR block time at the facilities
- Maintains provider delineation of privileges to determine appropriateness of schedule
- Ensures instrumentation and anesthesia is coordinated
- Enters patient demographics into EMR portals, ensures facility has all necessary paperwork needed to schedule a case
- Collects upfront monies due for surgery, assist in collecting balance dues if noted in the account
- Directs patient to get necessary clearance/pre-op testing completed prior to surgery and makes sure results are received and sent to the facility
- Facilitates the authorization process for all surgery, pain procedures and durable medical equipment.
- Communicates with providers and other team members of the guests' authorization, having awareness of delays, and providing continual communication with all.
- Maintains compliance with payer-specific reimbursement guidelines.
- Responsible for tracking, obtaining, and extending authorizations from various carries in a timely manner.
- Follows-up on and has confirmation of all authorizations obtained; I work to help find solutions when denials are received.
- Verifies benefits information for guests and obtain test precertification/authorizations when necessary.
- Formation of pricing estimate based off benefits combined with recommended surgeries, pain procedures and durable medical equipment
- My leadership is proactive.
- My work shows great attention to detail.
- My behaviors and standards model DOC's values and deliver a service experience that is unrivaled.
- I use active listening skills.
- My behavior is enthusiastic.
- I enjoy working as part of a team.
- I am flexible and adaptable.
- I am able to lift up to 50lbs.
- I am proficient in computer skills.
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Surgery Scheduler/Prior Authorization Specialist - Addison, United States - Direct Orthopedic Care
Description
Job Description
Job DescriptionMission
As the Surgery Scheduler/Prior Authorization Specialist, I report to the Director of Surgical Services. I create a connection with DOC guests and ensure that our value of tenacious caring occurs. I do this by understanding the value of communication, a helpful hand and the importance of relating to one's needs.
Lead Outcome
Core Responsibilities
I Exemplify the Following Competencies
