What are the responsibilities and job description for the Surgical Coordinator Orthopedics. position at Day Kimball Healthcare?

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.

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.

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

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.

Performs other duties as assigned

WORKERS’ COMPENSATION SPECIALIST

JOB SUMMARY

For the Surgical Coordinator that also functions as the Workers’ Compensation Specialist

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

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

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