Sr. Surgery Services Representative (H) Full Time Bascom Palmer Eye Institute Palm Beach Gardens, FL

Surgery Services Representative 2

Core Job Functions
Acquires operating room schedules and reconciles surgical and anesthesia records.
Verifies insurance information and takes appropriate steps to obtain any missing information.
Works directly with billing staff and physicians to ensure medical records are complete and in compliance with regulations.
Maintains an organized record of charges by batching patient records by date of service.
Responds to and resolves complex customer grievances.
Adheres to University and unit-level policies and procedures and safeguards University assets.

• Core Qualifications
• Education: High School Diploma or equivalent/relevant experience, certification or license
• Certification and Licensing: Refer To Department Description For Applicable Certification Requirements
• Experience: Minimum 3 Years Of Relevant Experience Required
• Knowledge, Skills and Attitudes:
• Ability to communicate effectively in both oral and written form.
• Skill in completing assignments accurately and with attention to detail.
• Ability to process and handle confidential information with discretion.
• Ability to work independently and/or in a collaborative environment.
• Proficiency in computer software (i.e. Microsoft Office).
• Multitasker
• Works well under unstructured work environments/processes.
• Flexible with shifts on day-to-day tasks and responsibilities.
• Able to switch rapidly between different tasks effectively.
• Adaptable to new responsibilities.
• Handles distractions well.
• Mets multiple daily deadlines.
• Skilled in prioritizing and organizing tasks.
• Manage large call volume daily 30+ calls

Department Addendum

Department Specific Functions
Establishes and maintains a close collaborative working relationship and open communication with providers, support clinical team, and patients.
Coordinates and schedules all pre-operative and post-operative visits, and surgical procedures promptly in the system in accordance with complex specialty provider instructions.
Validates patient identification by obtaining pertinent documents and verifying identity by using two main identifiers and scanning documents into system.
Creates a patient identification band for each patient in accordance with patient safety and risk management protocols and validates information when placing the band.
Interviews patients and verifies demographic and financial registration data in electronic system and makes appropriate changes as necessary including insurance coverage information.
Conducts critical communication with patients and legal guardian facilitating the understanding of and obtaining signature on legal, ethical, and compliance related documents that must be presented and thoroughly explained to the patient or legal guardian prior to services being rendered.
Ensures all required documents, consents, implants, or tissues are available prior to procedure.
Verifies insurance information, obtains benefits, and determines financial classification.
Reviews and identifies discrepancies in auto generated estimates and creates accurate detailed hospital and professional estimates as needed.
Explains insurance benefits/coverages, global/flat fee options, and collects co-payments, deductibles, co-insurance, and non-covered amounts for both hospital & professional fees prior to surgery.
Promptsly works all bypass warnings, registration work queues, and Medicare Secondary Payer Questionnaire, if applicable.
Confirms that Consent for Surgery has been signed by patient and provider and procedure listed is validated against surgery schedule, follows up if necessary.
Reviews and follows up with appropriate departments to ensure that all pre-op results are available prior to the procedure.
Orders, creates purchase orders, and keeps track of implants or tissues needed from external vendors, as needed.
Arranges for bed assignment or transfer, if applicable.
Works with healthcare team to resolve unique situations and troubleshoot issues.
Meets established individual and departmental key performance indicator goals: Co-pay, Previous Balances, Estimate Collections, Patient Satisfaction, Accuracy Rates, and Processing Time.
Responds to and resolves complex scheduling and billing inquiries, and patient grievances.
Cancels and reschedules all visits and surgeries as needed due to Provider Call Outs, or weather conditions.
Cross trained and able to float and cover other surgery specialties.
Serves as subject matter expert for the surgery specialty.

Benefits

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.