Scheduling & Insurance Verification 7122

Company: Vail Health
Location: Vail
Posted on: March 6, 2020

Job Description:

POSITION PURPOSE:

• Schedules surgeries in a timely and efficient manner, working with schedulers, clinical staff, and physicians. Works closely with clinical managers to ensure appropriate scheduling of patients at an ambulatory surgery center. Acts as a liaison between physicians, nursing, and business office staff to ensure appropriate data collection, compliance with third party payers, and federal and state regulations. Also responsible for insurance activity prior to the procedure date. Contacts third party payers for benefits, eligibility and pre-authorization. Acts as a financial counselor regarding insurance and payment options. JOB FUNCTIONS:
  • Accurately schedules procedures using the most appropriate CPT codes for the procedure(s). Verifies that the CPT code is a Medicare-approved ASC procedure, and that the physician is credentialed to perform that procedure. Coordinates with the physician's office when a required pre-determination has not been obtained.
  • Works closely with Physician Office Schedulers and the VVSC OR Manager to ensure accuracy of the Surgery Center's schedule and to ensure all equipment, supplies, etc. are available for the scheduled (next day's) procedures. Meets regularly with the OR Manager and Pre-Op/PACU Manager to review next day's schedule, and coordinates with OR Manager when adding additional cases to the next day's schedule after noon on the proceeding day. Consistently reviews and informs all Physician Office Schedulers about open block time and attempts to maximize room utilization on a daily basis.
  • Tracks certain schedule changes including, but not limited to, source of cancellations, add-ons, transfers, etc.
  • Assists the scheduling supervisor with the block time utilization analysis and provides supporting documentation to Administration when questions arise.
  • Responsible for answering all phone calls appropriately and returning calls in timely manner. Calls received after 6:00 p.m. are to be returned the morning of the next business day in a timely manner.
  • Verifies insurance benefits, eligibility and pre determination requirements for all scheduled patients. Follows procedures to ensure accuracy in insurance verification and coordinates to obtain any missing patient information and to verify accuracy of all insurance information. Attempts to contact patients at least 5 business days in advance when possible. Notifies patients of estimated liability and acts as a financial counselor regarding insurance and payment options that are in compliance with surgery center policy.
  • Accurately completes the "Insurance Verification" form. Clearly notes the amount the patient is required to pay at time of service, and documents any additional information that may be helpful to the admission staff. Inputs all benefit, eligibility and pre-determination information into AdvantX. Enters additional information in the "comments" section in Advantx.
  • Assists with giving directions and providing general surgery center information, and assists and backs up all other front office staff positions, as needed. Interacts with external and internal parties with courtesy and sensitivity.
  • Works closely with registration staff to ensure that the process is running as smoothly and efficiently as possible.
  • Responsible for coordinating with other staff members and schedulers when out of the office to ensure any scheduling activity continues seamlessly.
  • Role models principles of a Just Culture.
  • Perform other duties as assigned. Must be HIPAA compliant. MINIMUM QUALIFICATIONS:
    • Experience:
      • Previous admitting or clerical experience preferred. Working knowledge of medical terminology and surgical equipment (machines, implants, etc) preferred. Knowledge of ICD-9-CM and CPT coding is desirable.

Keywords: Vail Health, Vail , Scheduling & Insurance Verification 7122, Other , Vail, Colorado