Surgery Counselor
About The Position
The Surgery Counselor (SC) helps patients understand the cataract surgery process, including the appointments, tests, surgical options, and potential out-of-pocket expenses required before and after surgery. The SC schedules cataract consultations requested by phone and sends informational brochures. The role greets patients at consultations, explains required appointments, then meets with patients after consultation to schedule surgery and related appointments, including advanced diagnostic testing. The SC explains standard and elective options and associated costs, including insurance co-pays. After the surgeon selects the appropriate lens and surgical technique, the SC discusses the recommendation with the patient, finalizes the patient's decision about an intraocular lens (IOL) upgrade when applicable, obtains required signatures, and collects out-of-pocket payments. The role complies with applicable state and federal regulations and coordinates information for business services functions, including CPT-10 and ICD-10 coding. It also demonstrates high-level customer service through Head+Heart, Together behaviors.
Requirements
- At least 2 years of related experience in an ophthalmic and/or health care environment.
- Detail-oriented.
- Able to build rapport with patients and efficiently explain appointments and scenarios.
- Comfortable discussing pricing structures.
- Able to put anxious patients at ease.
- Strong computer and organizational skills.
- Medical terminology and CPT-10 coding knowledge.
- Able to proficiently navigate three computer programs and operate a printer, telephone, photocopier, and fax machine.
Responsibilities
- Meet with patients after consultation to explain the process and surgical options and obtain signed consents.
- Schedule in-patient ophthalmology procedures at appropriate locations; review surgeon-prescribed medication instructions; coordinate pre-operative and post-operative exams; and maintain a patient tracking system with pre-procedure.
- Ensure the lens is selected in a timely manner before surgery and, when applicable, that an upgrade lens or treatment is prepaid; ensure the surgeon completes surgical orders and outside preoperative assessments are received.
- Secure prior authorizations, precertifications, and referrals from government agencies and out-of-plan referring physicians, and complete required forms and documentation.
- Respond to requests for further information from government agencies and insurance carriers; gather statistical information for physician or procedure audits or investigations when needed.
- Assist Business Services and Coding Departments with procedures and insurance requirements by providing requested information.
- Coordinate communication about fee and coding issues between physicians and business services.
- Review outsourced services for accuracy, send them to physicians for review, and return information to the appropriate department after making copies for medical records.
- Recognize and resolve issues related to insurance, billing, government regulations, and customer service.
- Make, take, and return patient calls about prescription directions, missed appointments, History and Physical requirements, surgery date and time confirmations, and potential rescheduling of appointments or surgery.
- Create and maintain weekly and monthly surgery itineraries for surgeons.
- Maintain surgery-related information; provide information for internal and external audits; and answer questions from auditors, administration, and government regulators.
- Serve as a resource person within the department.
- Perform other tasks as assigned.
- Schedule phone-in requests for cataract consultations and mail informational brochures to patients.
- Greet patients arriving for consultations and explain required appointments; after consultations, schedule surgery and associated appointments, including advanced diagnostic testing.
- Explain standard and elective options and possible out-of-pocket expenses, including insurance co-pays; discuss the surgeon's recommended lens and technique, finalize the patient's IOL upgrade decision when applicable, obtain final signatures, and collect out-of-pocket expenses.
- Comply with applicable state and federal regulations and coordinate information for business services functions, including CPT-10 and ICD-10 coding.
- Demonstrate high-level customer service through Head+Heart, Together behaviors.
- Comply with safety instructions and safe work practices, contribute to safety discussions, and promote a safe work environment.
- Maintain regular and timely attendance and protect confidentiality.
- Participate in and support the Corporate Integrity Program, including required compliance education and training and adherence to organizational policies and procedures.
- Complete mandatory education and organizational requirements on time.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
