JOB DESCRIPTION

JOB TITLE:              Surgery Schedule and Authorization Specialist

REPORTS TO:         Billing Office Manager

JOB STATUS:          Full-Time

JOB RESPONSIBILITIES:

Responsible for tracking and resolving current and outstanding payment issues at Parkway Surgery Center (PSC) and ensure that all duties assigned are done in a timely manner

JOB FUNCTIONS:

Perform the following duties on a daily basis or as needed.

• Notify appropriate manager, materials manager, and/or vendor when scheduling implant surgeries or when specialty medications are needed.
• Communicate with physicians and clinic staff regarding patient orders and surgery schedules.
• Posts procedure and diagnosis codes in patient’s case history in computer system at the end of each day based on physician and intraoperative notes.
• Works with Nurse Manager and ASC Business Office Manager on physician schedule conflicts. 
• Follow all written policies and procedures of the surgery center
• Follow OSHA and HIPAA Standards.
• Collect, sort, and distribute mail as necessary.
• Prepare Surgical Authorizations.
• Review accounts receivable reports daily; bring large balances and rejection patterns to the attention of the Business Office Manager.
• Submit appeals for denied claims with appropriate documentation.
• Respond to payer requests for documentation and send in a timely manner.
• Proactively stay abreast of payer changes that impact the practice.
• Speak with patients who have large, outstanding balances and attempt to collect on the account or arrange a payment plan.
• Schedule mutually acceptable appointment dates for patients and physicians using computerized scheduling system.
• Contacts patients and families regarding surgery date and preoperative instructions.
• Interact with patients, physicians, and other staff both within the surgery center and at physician practices providing accurate, timely, and responsive information.
• Coordinate processes and route all paperwork as required to meet the physician and facility requirements.

• Make outbound calls and send correspondence to patients in delinquent status.

• Review self- pay accounts and send delinquent accounts to collection agency on a regular basis.
• Collections, prepare collections account to the Collection Agency for payment
• Review patient and insurance refunds. Send request for refund checks to accounts payable department.
• Involve Business Office Manager when additional support is required to perform job
• Cross train in all aspects of the Business Office Department and assist when needed.
• Follow appropriate chain of command when problems or concerns arise.
• Perform other duties as assigned.

PRINCIPLE ACCOUNTABILITY:

Provide assistance to ensure the center’s objectives are achieved in an effective, timely, and efficient manner.

JOB REQUIREMENTS:

• Excellent communication skills, both written and verbal.

• Working knowledge of Medicare, Medicaid and Commercial insurances.
• Knowledge of CPT and ICD-10 is required.
• Work in a fast-paced office environment, and sit for long periods of time in front of computer while talking on the phone throughout entire workday.
• Ability to handle daily stressful situations due to the nature of the job, as well as work independently and stay focused on task at hand.
• Willingness to work as part of a team, working collaboratively with others to achieve goals, solve problems and meet established organizational objectives.
• Maintain detailed knowledge of practice management software and other computer software as it relates to job functions.
• Attend and comply with OSHA, HIPAA, and OIG training programs as required.
• Attend all meetings as requested including regular staff meetings.
• Pursue and participate in education to remain current with changes in the Healthcare industry.

JOB RELATIONSHIPS:

Does not supervise any other employee. Supervised by the Business Office Manager.

As a representative of Parkway Surgery Center, all comments, attitudes, actions, and behaviors have a direct effect on the facility’s image and perceptions of quality service. Interaction with patients, families, physicians, referral sources, affiliating schools, visitors, volunteers, co-workers, supervisors, vendors, etc. must be in a manner that is friendly, supportive, courteous, respectful, cooperative, and professional. This behavior should promote an atmosphere of team work which is congruent with facility standards and guidelines to promote positive relations.

ENVIRONMENTAL CONDITIONS:

Ability to work effectively in a fast-paced environment.

PHYSICAL REQUIREMENTS:

Must possess visual and auditory abilities to communicate with patients and vendors.  Requires ability to sit for prolonged periods of time. Manual dexterity needed. Good vision. Ability to type.

COMPLY WITH PSC POLICIES:

• Attends 50% of departmental meetings per year, 50% of facility meetings per year and is accountable for the information presented at all departmental and facility meetings by initialing minutes as directed.
• Consistently reports to work on time and begins work promptly and performs duties for entire scheduled shift.
• Maintains absentee rate within limits of status.
• Notifies appropriate department manager of absences and tardiness in a timely fashion.
• Attends all mandatory PSC in-services and watches mandatory videos as evidenced by attendance records.
• Reads new policies and documents as instructed.
• Volunteers to serve on PSC committees as the need arise.

The above statements reflect the general outline considered necessary to describe the principle functions of this job. It shall not be construed as a detailed description of all work requirements of the job.