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  • 18518 Hardy Oak Boulevard
    San Antonio, TX 78258
  • Trudy Wiig

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FT & PT Admit/Insurance Verification/Scheduler

St. Raphael's Surgery Center • San Antonio, TX

Posted 15 days ago

Job Snapshot

Full-Time/Part-Time
Travel - None
Experience - At least 3 year(s)
Degree - High School
$15.00 - $18.00 /Hour
Healthcare - Health Services, Insurance
Health Care, General Business, Other
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Job Description

St. Raphael’s Surgery Center

Job Description

Job Title:  Insurance & Scheduling Coordinator    Department:  Administration

Exempt:  No                            Supervisor:  Administrator or Business Office Manager

Job Summary

Contacts all insurance companies to verify description of patient(s) medical plan benefits. Interacts with physicians personnel and patients regarding financial issues, assures appropriate payment for procedures.

Plans and schedules for surgical cases for the surgery center. Manages functions related to scheduling of all Center cases and is the primary liaison between the Center and the physician’s office staff

Essential Duties and Responsibilities: include the following; and other duties as may be assigned from time to time related to insurance coordination and scheduling of Center cases; report generation in the areas of responsibility - front office, scheduling and insurance verification.

Contacts all insurance carriers per patient, to insure proper coordination and reimbursement of benefits.

Breaks down managed care contract reimbursements and estimates patient(s) financial responsibilities.

Assess patients estimated out of pocket expense, makes financial arrangements in lieu thereof.

Informs business office manager or administrator of financial obligations at least two or more weeks prior to date of surgery.

Maintains daily deposit log and daily upfront collections log and records all mail and money intake on the log; uses e-bridge to communicate with the external billing office through Vision.

Is the Scheduling Coordinator: Schedule surgeries, coordinates schedule between Surgery Center and doctor’s offices.

Gathers all detailed information for the patient’s chart, such as type of procedure, supplies, special equipment required, insurance information, etc. Enters all patient information in Vision and records the data for the Surgery Schedule and prints a daily update to the surgery master schedule.

Maintains master schedule to ensure coordination between doctors, anesthesia, lab and insurance carriers.

Gathers all detailed information for the patient’s chart, such as type of procedure, supplies, special equipment required, insurance information, etc. Enters all patient information in computer system.

Schedules all surgical anesthesia services required according to doctor preference and availability.

Assures that pre-certification/referrals are in order.

Confers with OR Circulating RN, Materials Manager and Administrator to determine status of scheduled surgeries. Alters schedules to meet unforeseen conditions.

Works closely with the Administrator regarding approved privileges for each physician and when anesthesia is required to be scheduled by the Center.

Maintains and balances petty cash box as needed on a regular basis.

Gather the mail daily and dispenses it to the appropriate individual for processing (marks date received).

Interacts appropriately and effectively with all patient/others regardless of age or ethnic background.

Initiates safe practices and is knowledgeable about current center policies and procedures. Specific procedures and practices related to abuse and neglect, sentinel events and response, variance reporting, response to sentinel event alerts, participation in root cause analysis and other key policies and procedures is required.

Assists with environmental hazard and infection control surveillance participate in emergency preparedness drills.

Follows all equipment safety guidelines and is personally responsible for knowledgeable use and care of all business equipment.

Qualification Requirements:  To perform this job successfully, and individual must be able to perform each essential duty satisfactory. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or experience:  High School education and/or equivalent; up to one year of related experience or training or equivalent combination of education and experience. Within the first 90 days of employment and annual thereafter, must complete QI training and be able to recite program objectives, key requirement, process steps and goals as outlined below.

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Language Skills:  Ability to read and comprehend simple instructions, daily correspondence and memos. Ability to write simple correspondence. Ability to effectively present information in one on one and small group situations to customers, clients, and other employees of the organization.

Reasoning Ability:  Ability to apply common sense understanding to perform detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.

Physical Demands: The physical demands described here are representatives of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job the employee is regularly required to sit. The employee frequently is required to use both hands to finger, or feel objects, tools, or controls and reach with hands and arms. The employee is occasionally required to stand, walk, stoop, kneel, crouch or crawl, hear and talk. The employee must occasionally lift and/or move up to 10 pounds.

Work Environment:  The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

Comments:  Decision-making is routine. For example, this employee must choose an anesthesiologist, make changes or reschedule cases when situations warrant.

Insurance & Scheduling Coord                1  

Job Requirements

Job Purpose:
Full-Time, Mon-Fri, 9:00 AM – 5:30 PM and Part-Time, Mon-Fri, noon to 6:00 PM Insurance Verification, Admissions and Scheduling for an ambulatory surgery center.

Duties:
* Insurance verification and calling patients regarding meeting their deductible (prior to surgery) and co-insurance requirements (arrangements made prior to or on day of surgery).

*Calling patients the day before surgery to confirm their surgery times.

* Admitting patients at the front desk (ASKING FOR MONEY).

* Updates surgery schedule with each surgery addition using Vision software (similar to SIS and Advantx).

* Make medical records for use in new patient record setup, labeling and adding labs, etc.

 

*Able to understand Medical Record terminal digit filing system is a plus.

 

*Must be computer savvy as nearly all work is done by computer.

Skills/Qualifications:
Ambulatory Surgical Center Experience in Scheduling, Medical Records and Insurance Verification; must understand insurance deductibles, co-insurance, primary and secondary payors; must be comfortable with collections; able to converse with physician office schedulers and understand some medical terminology. If you have not worked in an Ambulatory Surgery Center or are not comfortable asking people for money or asking them to pay their money owed, please do not apply.

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