Patient-focused, service-oriented, representative of the practice and health system.

Responsible for scheduling patients for specialized procedures upon receipt of, and according to, providers’ orders using comprehensive knowledge of case types and resource availability. Verifies and/or collects accurate patient demographic data, insurance and guarantor information, pre-certifications, resource availability, CPT, HCPCS, and ICD-10 codes. Communicates needs for special surgical resources to the appropriate party. Resolves scheduling and resource conflicts. Validates surgical schedules with physicians and ensures optimal operating schedule, resource utilization, and block time.

Utilizes patients’ insurance information and demographics in order to confirm the patients’ eligibility for coverage of medical services. Reviews insurance documents and/or reports to determine if limitations exist, ensuring that insurance will cover required medical service. Communicates findings with patient and members of the clerical and clinical teams. Works collaboratively with the Central Billing Office and hospital services to maintain integrity of claim cycle.

Ensures proper authorizations have been obtained for patient procedures, visits, and services. Requests authorizations as necessary.

Promptly answers calls in a courteous and professional manner, assisting patients, answering general questions, providing practice information, and transferring callers or referring questions to the appropriate parties. Maintains a professional appearance and attitude, and an orderly, clean workspace to create a positive impression on patients and visitors. Protects patients’ privacy by maintaining confidentiality of medical, personal, and financial information. Coordinates patient interpretive services, accommodates patient disabilities, and readily assists patients with completion of forms.

Assists in numerous clerical tasks, and provides administrative support to the Practice Manager. Uses interpersonal skills to work effectively within the practice team, establish good working relationships with coworkers, foster a collaborative interdepartmental culture, and provide a positive experience for patients and visitors.

Minimum of 18 months previous experience working in an office or hospital setting as a customer service representative or health care representative – Required

Schedules patients for procedures across multiple hospital departments (including, but not limited to Specials, OR, Cath Lab, EP Lab, Surgery Center). Ensures procedural cases are scheduled timely, completely, accurately, with proper urgency, and with consideration to necessary surgical resources (personnel and equipment). Obtains additional information from ordering provider as needed to complete scheduling tasks.

Manages communication with surgery patients. Educates and clarifies information with patients and patients’ families and/or caregivers regarding upcoming procedures and related patient visits or studies. Escalates questions or concerns to the medical professional as warranted. Coordinates patient interpretive services, accommodates patient disabilities, and readily assists patients with completion of forms.

Plays an active role in revenue cycle process. Executes timely pre-certifications and prior authorizations with payors. Documents and verifies accuracy of authorization numbers, benefits and eligibility, patients’ cost share responsibilities and estimates. Performs accurate and timely charge entry based on physician documentation when applicable and as assigned by management. Assists as needed in denial avoidance and recovery efforts.

Uses interpersonal skills to work effectively within the practice team, establish good working relationships with coworkers, foster collaborative interdepartmental relationships, and provide a positive experience for patients and visitors. Updates practice call/procedure schedule when required.

Error prevention. Repeats appointment dates, times, and locations during call with patient and hospital coworkers. Partners with interdepartmental and interdisciplinary teams to prevent posting errors and case delays.

Assists in clerical tasks, provides administrative support to the Practice Manager, and completes other duties as assigned (especially including, but not limited to, patient scheduling, registration, training, referral and order coordination and fulfillment, processing inbound communications, and direct physician support).