Employment Type : Full-Time
Summary Coordinates activities related to pre-authorization of surgical procedures in order to ensure prompt reimbursement; Supports surgical coordinators in all aspects including serving as primary backup. Ensures that all authorizations and pre-certifications are obtained to expedite reimbursement. Contacts insurance companies via telephone, facsimile, and computer; Exchanges all correspondence necessary to authorize surgery. Maintains current knowledge of insurance company requirements, medical terminology, and diagnosis and procedure codes. Verifies patient information as appropriate and obtains any missing information. Reviews record and physician forms for completeness. Coordinates surgery related paperwork and authorization information with the appropriate ASC or Hospital, and the Central Business Office. Communicates to all involved parties any unusual circumstances involving patient insurance benefits, coverages, or requirements. Cross trains into other areas; including front desk, and serves as primary back-up for Surgical Coordinator. Maintains professional demeanor at all times with patients, physicians, and co-workers Observes strict patient confidentiality. This job has no supervisory responsibilities. To perform the job successfully, an individual should demonstrate the following competencies : Problem Solving - Identifies and resolves problems in a timely manner; Develops alternative solutions. Technical Skills - Assesses own strengths and weaknesses; Strives to continuously build knowledge and skills. Customer Service - Manages difficult or emotional patient situations; Responds promptly to patient needs; Responds to requests for service and assistance; Meets commitments. Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things. Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions. Ethics - Treats people with respect; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values. Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions. Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Sets and achieves challenging goals and objectives; Develops realistic action plans. Professionalism - Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments. Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality. Measures self against standard of excellence. Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly. Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events. Attendance/Punctuality - Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time. Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to hours necessary to reach goals.; Completes tasks on time or notifies appropriate person with an alternate plan. Initiative - Volunteers readily; Seeks increased responsibilities; Takes independent actions and calculated risks; Demonstrates persistence and overcomes obstacles; Asks for and offers help when needed. Innovation - Displays original thinking and creativity; Meets challenges with resourcefulness; Generates suggestions for improving work; Develops innovative approaches and ideas; Presents ideas and information in a manner that gets others' attention. The noise level in the work environment is usually quiet. Education and/or Experience High school diploma or general education degree (GED); and six to twelve months related experience and/or training; or equivalent combination of education and experience. Language Skills Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to patients, co-workers and physicians. Reasoning Ability Ability to apply common sense understanding to carry out 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 representative 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; use hands to finger, handle, or feel and reach with hands and arms. The employee is frequently required to stand and walk. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
Supervisory Responsibilities
Competencies
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.
Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. 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