Sr. Physician Services Specialist, Ortho, Full Time, First Shift

About the role

This position serves as an ambassador of care for patients before and after visits, and before and after surgical procedures in clinic and the OR. The role supports clinics and providers, assists leadership with training and education, and steps in to provide expert support to non-senior team members.

Responsibilities

• Answers telephone and directs to correct person if needed.
• Manages Outlook Calendar for providers within the clinic.
• Manages office incoming mail.
• Manages incoming communication related to case authorization.
• Validates registration information with patients and verifies all third-party payors.
• Engages in population-appropriate communication.
• Gives clear instructions to patients/family regarding treatment, diagnostic, procedural, or surgical plans as directed by clinical team.
• Makes sure follow-up for planned diagnostic procedures is done according to standard of care.
• Prepares for upcoming clinics related to procedural planning.
• Captures clinic template changes required to meet case and procedural obligations.
• Captures provider calendar related to faculty obligations.
• Performs in-basket management tasks.
• Completes FMLA, Disability, BWC forms.
• Identifies and responds appropriately to unique psychological needs or those associated with religious/cultural norms.
• Assists leadership with identification, training, and orientation of new hires.
• Participates in process improvement initiatives.
• Aids in the development of department policies and SOPs.
• Schedules and coordinates patient services, surgeries, tests, and other procedures as needed.
• Coordinates all pre-procedural testing, diagnostic studies, medications, and other services as needed.
• Communicates with patients via phone and in person regarding scheduling related matters.
• Manages OR block time with providers Outlook calendar if applicable based on department guidelines.
• Reviews and coordinates case changes identified with leadership related to urgency, case order, or unforeseen delays.
• Helps review daily schedules as needed and makes leadership aware of changes or discrepancies.
• Liaises between staff and procedural areas for scheduling needs.
• Coordinates with all product or device representatives for cases.
• Completes complex coordination with co-surgeons in other surgical practices for joint case authorization and scheduling.
• Completes case request and referral order entry.
• Performs audits on patient records/registration for insurance billing and compliance.
• Reviews office notes to ensure all required items are noted for authorization requests.
• Performs pre-authorizations and pre-certifications using care management protocols.
• Utilizes payer portals to complete case, procedure, and visit authorizations.
• Coordinates peer-to-peer reviews for pending case authorization.
• Obtains CPT codes for all surgical and procedural cases and submits for authorization.
• Obtains retro authorizations as needed.
• Coordinates with utilization review for authorization status to avoid financial risk.
• Updates documentation in referral tab with all authorization updates.
• Coordinates with peer reviewers for pending case authorization.
• Investigates patient satisfaction discrepancies and makes recommendations to resolve and ensure future discrepancies are not repeated.

Qualifications

• High School Diploma or GED.
• No specific licenses or certifications required.
• Minimum of 3-5 years of equivalent experience.

Skills

• Excellent communication skills.
• Strong organizational and administrative skills.
• Ability to manage multiple tasks and prioritize effectively.
• Knowledge of medical terminology and procedures.
• Experience with scheduling and coordination.
• Proficiency in Microsoft Office, particularly Outlook.

Benefits

Join our team to BE UC Health. Be Extraordinary. Be Supported. Be Hope. Apply Today!

Pay

N/A

Schedule

N/A