Surgical Scheduling Specialist - PMPH

Scheduling and Pre-Registration

Schedules surgeries and pre-admission testing in scheduling system.

Answers inbound telephone calls, retrieves messages, faxes and emails in a professional, timely and efficient manner per department protocol.

Fulfills prescribed PennChart searches, including 3-3 search and screening for any other Date of Service appointments.

Reviews or collects demographic, insurance, and clinical information to establish completeness and accuracy of data as per protocol.

Enters data into appropriate fields within the scheduling system and attaches any clinical information such as a booking sheet to the case.

Moves/cancels visits based on physician and/or patient availability issues.

In addition, may coordinate additional resources such as extra staffing, equipment and supplies.

Confirms and coordinates the scheduled surgeries the day prior to procedure.

Insurance Verification and Medical Necessity

Ensures all insurance information is entered correctly and is active at the time of scheduling.

Utilizes on-line verification system(s) or places phone call to insurance company prior to the procedure.

In addition, makes sure all necessary referrals, authorizations and/or pre-certifications are in place prior to patient's scheduled appointment on emergent cases.

Utilizes scheduling system to prioritize workload based on service, date, and insurance company requirements.

Review applicable worklists within scheduling system to identify any additional information required to complete the case.

Education and Development

Must pass and stay current with all Penn Medicine’s educational requirements.

Maintains working knowledge of Penn Medicine’s insurance verification tools, including insurance guidelines.

Maintains working knowledge of Medical Necessity requirements for commercial and governmental payers.

Maintains working knowledge of ICD-10 coding methodologies to accurately identify diagnosis codes to support medical necessity.

Interdepartmental and Revenue Cycle Development

Promotes teamwork both internally and externally across all department lines.

Works in collaboration with other departmental associates as well as other hospital associates supporting their efforts though teamwork and the acceptance of additional assignments.

Accepts responsibility for own actions, while taking ownership of departmental outcomes.

Maintains a strong working relationship with physicians and departments at Penn Medicine to ensure maximum communication and coordination of service.

Performance Improvement

Supports the Performance Improvement goals of the department.

Collaborates with other staff, within and outside the department, to develop means of enhancing patient care and service.

Core Values

Takes initiative to resolve accounts with and without supervision.

Works toward department goals and visions as an individual and Team Member.

Maintains confidentiality of patient information in accordance with Penn Medicine Policies.

Demonstrates actions to reasonably prevent, detect and report unethical and unlawful business practices.

Familiarity with the general usage and spelling for specific medical terminology.

Collaborates with various areas of the Penn Medicine Team to increase cash by decreasing denials.

Qualifications

H.S. Diploma/GED (Required)

Bachelor's Degree (Preferred)