Job Description

MAJOR FUNCTION:

Surgical Business Services mission is to implement comprehensive surgical scheduling and revenue strategy to deliver optimal patient care and improve department throughput. This position oversees the administrative operations of the Surgical Business Services. Serves as liaison with patients and associated departments during surgical journey. Responsible for the coordination of care for patients having a surgical procedure at each Medical Center and the Vineland Endoscopy Center.

QUALIFICATIONS:

Education & Experience

• College coursework or degree,
• Minimum 0- 1 years' experience in a hospital, physician practice setting required.
• Experience in health insurance environment or related work experience required.
• 0-1 years of surgical scheduling experience preferred.
• Experience scheduling in Cerner and using applications such as NJ Shine, insurance verification/ eligibility tools, patient liability estimation tools (Navi Net, Waystar and Soarian Financials) preferred.
• Certified Medical Assistant, Certified Nurse’s Aide experience preferred.

Knowledge & Skills:

• Strong knowledge of clinical / medical practice operations, procedures, medical/ surgical terminology, anatomy, and administrative procedures required.
• Demonstrating a proficiency of Microsoft computer applications with a minimum score of 80%.
• Strong organizational and analytical skills; innovative with ability to identify and solve problems required.
• Able to adapt, prioritize and meet deadlines required.
• Maintains high level of knowledge and skill in the use of appropriate electronic systems to obtain and provide information.
• Always courteous and maintains a pleasant, professional voice during phone communications and co-workers.
• Ability to use multi-line telephone system, fax, typewriter, copier.
• Must be proactive, self-motivated, able to multitask and organize work independently.
• Willing to extend a helping hand in any person in need of our services.
• Understanding of DRG’s, Surgical/ Medical ICD-10 codes and CPT/HCPC Codes and Modifiers.
• Must be able to communicate effectively with physicians, patients, and the community.
• Capable of establishing good working relationships with both internal and external customers.

Position Responsibilities

Surgical Scheduling Responsibility: • Oversee the administrative operations of the Surgical Services Business Office. Serves as liaison with patients and other departments during surgical encounter becoming a "customer/patient advocate". • Responsible for the coordination of care for patients having a surgical procedure at multiple hospital and endoscopy center. • Receive requests to schedule procedures from physician offices and accurately schedules and re-schedules complex patient procedures and appointments according to established guidelines. • Accurately schedules the procedure and pre-admission testing appointments utilizing the information on the Request for Service (RFS) via NJ Shine. • Should there be deviations of the patient's name, date of birth, or scheduled procedure from the information on the Request for Service, verification must be initiated by calling the physician's office personnel and ask for confirmation. If any information differs from what was identified on the Request for Service, another Request for Services must be forwarded to the Surgical Business Office with the correct information. • Provides high level of coordination and office support to meet Surgical Services and physicians' needs. This includes maintaining operating room schedules and OR block time management, collaborating with various hospital and surgical offices related to scheduling the appropriate needs for surgery, which may include co-surgeon collaborations, interventional radiology, intraoperative ultrasound, nuclear medicine, Cytology, Histology (frozen section), Cardiology and breast imaging. • Urgent/Emergent case scheduling will be scheduled and communicated to applicable departments, ie. Pre-Admission Testing, Same Day Surgery, Endoscopy, Operating Room and Registration. • Must be able to recognize and respond appropriately to urgent/emergent situations per protocols. • Provides accurate information so that all departments may view daily and maintains open communication with hospital departments and physician offices regarding schedule changes. • Providing arrival times and explaining instructions to patients before to the procedure date. Collaboration with Preadmission Testing to ensure no delays in surgeon case flow. • Interacts with patients, physicians, and other staff both within the Clinic and at outside facilities providing accurate, timely and responsive information. • Vendor notification of surgical case if after 1500 for next day cases. • Provides physician text case start time notification. Fiscal Responsibility: • Assure that all the appropriate clinical and insurance coding information is collected for the Inspira Health Position Profile 4 surgery schedule for the network. • Registers patient in our Soarian Financial system. • Verifies insurance of new and returning patients. • Interacting with patients, payers, and providers to gather information necessary for accurate scheduling and registration including assigning of appropriate Medical Record Number/account number, scheduling, referral/authorization, and point of service payment collection functions. • Responding to customer billing and payment inquires as needed. Maintains understanding financial services and resources available to patients such as Charity Care and Medicaid eligibility. • Communicating with insurers to confirm coverage on procedures and receive payment for procedures once administered. • Obtain appropriate insurance benefit information, referrals, and authorizations prior to a patient's appointment. Working knowledge of payor pre-cert and referral guidelines for scheduled elective procedures and notifies physician office and/or patient at time of scheduling. • Collecting surgery prepayments by calculating the amount due from the patient based on deductibles, copayments, coinsurance. Administrative Responsibility: • Functions as a point person/ subject matter expert for all surgical and administrative questions/issues. Monitors and uses systems to execute tasks, such as Cerner, Soarian Financials, NJ Shine, Microsoft Outlook, Teams, Excel, insurance verification / eligibility tools, patient liability estimation tools. • Books surgeries based on physician volume maintaining appropriate standard turn-around times. • Adheres to the Block assignments of specific physicians and /or physician groups. • Identifies scheduling barriers and implements solutions to improve scheduling results based on predetermined goals. Working closely with the OR team in utilizing block time and scheduling procedures within providers schedules. • Meet personal/team qualitative and quantitative targets. • Cross covers other staff members, e.g. breaks, lunches, vacations, during variations in workflow as needed. • Participates in periodic staff meetings or other departmental meetings. • Perform/participate in special projects as may arise from time-to-time. Participation in weekend and holiday "On-Call" rotation: • Covers the staff rotation of weekend on-call schedule from 5:30pm Friday evening to 7: 00pm Sunday evening. • Participates in rotational holiday on call schedule from 7:00am to 7:00pm on designated holiday • Communicate any coverage changes to the on-call schedule to Supervisor/Manager prior to the scheduled weekend/holiday Inspira Health Position Profile 5 • Utilize the provided on-call cell phone and computer/tablet to perform on call functions. • Accurately schedule urgent/emergent case scheduling for the Surgical Services department. • Communicate the urgent/emergent scheduling to the on-call team at Inspira Medical Center-Vineland and to the Nursing Supervisor at Inspira Medical Center Elmer. • Maintain patient confidentiality (HIPAA) when scheduling procedures and communicating with physicians and staff.

Physical Requirements

Place an N, O, F or C in the boxes below

N: Never O: Occasionally (80%)

LiftingOStandingOSittingCLifting 20-50lbsOClimbingFKneelingOLifting>50lbsNCrouchingOReachingOCarryingOHearingCWalkingFPushingNTalkingCVisionC Environmental ConditionsNoiseFVaried TemperaturesNCleaning AgentsONoxious odorsNPatient ExposureNOperative EquipmentN

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