Surgery Scheduler- Plastic Surgery

UVA Health•Charlottesville, VA

7h•Onsite

About The Position

Under the direction of the manager or designee, this role supports the functions of the Scheduling Office by facilitating and producing the ORMIS Daily OR Schedule and its supporting documents in a timely and accurate fashion. The position requires a high level of attention to detail, autonomy, and the ability to work as part of a collaborative team. It involves direct patient interaction, coordination with providers and clinical staff, and management of complex scheduling tasks within various electronic health record systems.

Requirements

High School Graduate or equivalent required.
3 years’ experience in a clinical setting (hospital, surgery center or ambulatory clinic) in an administrative or clinical role required (for external candidates).
Demonstrated proficiency in the duties of the Access Associate Senior role (for internal candidates).
Familiarity with current ICD-10 and CPT codes.
Comprehension of insurance data, benefits, in/out of network issues, notification requirements, pre-determination services and medical diagnosis.
Ability to work as a part of a collaborative team with considerable autonomy and with attention to detail.
Knowledge of medical terminology.
Knowledge of the International Classification of Diseases (ICD-CM) to classify patient sickness and disease.
Knowledge of the Current Procedural Terminology (CPT) for describing medical, surgical and diagnostic services.

Nice To Haves

Associates Degree in a related field preferred.
CHAA or Certified Revenue Cycle Representative (CRCR) by HFMA required within 18 months of hire date (for Access Lead positions).

Responsibilities

Locate order on the Depot and accurately schedule procedures in the proper Epic system such as OpTime, Cupid, or Radiant.
Scrub case orders for accuracy and completeness, ensuring diagnoses and procedures match. Review all OpTime case data for errors and omissions.
Reconcile laterality issues such as missing laterality and mismatches between diagnosis and procedure.
Escalate case orders and laterality issues back to the ordering provider for any needed corrections.
Order special grafts and tissues as needed through coordination with vendors and the clinical team.
Place and/or move cases on the scheduler grid called the Snapboard to correspond with time/room requirements.
Provide case duration estimates, comparing historical averages with surgeon estimates and accounting for room turnover time and other factors.
Add case information to additional databases such as Jamitron per departmental guidelines.
Ensure optimization of providers’ schedules by promptly moving patients up if there are cancellations.
Reschedule surgical cases/procedures as needed and inform necessary parties about changes to the schedule.
Schedule complex joint surgical cases as needed.
Recommend the necessary/appropriate doctor preference cards and supply picklists for each case.
Schedule appointments to the correct provider, including all appropriate information, and coordinate appointments on the same day when available.
Utilize advanced knowledge of Access tools and workflows to serve as an integral part of the care coordination team.
Utilize decision-based tools to facilitate securing the right appointment with the right medical provider or team.
Schedule Pre-Op and Post-Op appointments within correct time frames and coordinate/confirm with patients.
Maintain competence in the use of scheduling and web applications.
Ensure appointments are made appropriately and correctly, including the right patient, to the right provider, for the right amount of time, with the right type of visit, and using the right process.
Facilitate health care team discussions about complex patient scheduling needs.
Schedule multi-specialty patient appointments efficiently.
Take ownership for resolving scheduling conflicts and communicate with the management team and care providers to resolve scheduling issues.
Request and/or send records to Health Information Services in a timely manner.
Obtain required insurance information and load or verify for each appointment scheduled.
Accurately complete required tasks and fields in pre-registration.
Investigate referring provider or patient concerns when complaints are brought forward.
Demonstrate effective communication, decision-making, and organization skills to ensure efficient job performance and job success.
Educate patients on pre-surgery/procedure requirements and what to expect on the day of the surgery/procedure based on information provided by the clinical care team.
Appropriately escalate clinical questions.
Refer patients to the Pre-Evaluation Testing Center (PETC) as needed.
Communicate vital changes to the surgical/procedural schedule such as Add-on Same Day Surgeries using appropriate communication pathways to all impacted parties.
Manage the provider calendar by capturing and communicating out-of-office dates and releasing OR time for use by another provider.
Set work priorities to accomplish tasks/goals.
Handle confidential matters appropriately.
Demonstrate familiarity with current ICD-10 and CPT codes.
Communicate with department billing staff in a timely manner to ensure accurate pre-certification/authorization information is aligned with accurate billing of services.
Consistently demonstrate comprehension of insurance data, benefits, in/out of network issues, notification requirements, pre-determination services, and medical diagnosis to ensure that all pre-authorizations are completed prior to the date of service.
Consistently demonstrate sound judgment about when to involve providers or other health care professionals in the pre-authorization or denial process.
Educate patients, parents, guardians, and/or appropriate designee on the managed care process and communicate authorizations if needed.
Review potential financial obligations when appropriate.
Communicate payments due at the time of service and explain the risks of ‘going out of network’ for services.
Inform patients about the authorization status as necessary.
Prepare patient financial liability estimates and take payment as needed.
Demonstrate skill in the use of telephone technology.
Provide high-level customer service to referring providers and referred patients.
Establish initial contact with referring providers and referred patients by telephone.
Provide patients with an overview of the procedure process.
Manage more complex patient calls, using appropriate customer service skills.
Ensure patients complete pre-op requirements prior to the date of surgery.
Establish positive relationships with referring providers, referred patients, and referring provider office staff.
Assist with operational patient flow as applicable; perform problem-solving.
Advocate for patients by helping them navigate through the system.
Direct and assist patients, families, and staff in accessing appropriate resources.
Develop tools to assess patient referral processes with respect to efficiency and customer service.
Perform all other related tasks which would facilitate the flow of patients through the process, or which would enhance the quality of service to patients.
Implement practice/procedural changes accurately and in a timely manner.
Maintain current working knowledge; adhere to Health System and departmental policies and procedures.
Provide cross-coverage for registration and scheduling, as necessary.
Verify patient demographic and additional identifying information appropriately.
Accurately complete required tasks and database information prior to forwarding the case.
Exhibit a thorough working knowledge of scheduling and insurance practices.
Use the Department Appointments Report (DAR) to ensure clinic operations run efficiently.
Verify providers’ orders are present, accurate, and complete by applying knowledge of medical terminology, the International Classification of Diseases (ICD-CM) to classify patient sickness and disease, and the Current Procedural Terminology (CPT) for describing medical, surgical, and diagnostic services.
Foster the education and development of others through precepting new employees and role modeling behavior.
Maintain a positive environment conducive to the education of coworkers through precepting, mentoring, teaching, orienting, role modeling, and team participation.
Complete annual mandatory training activities within established timeframes.
Ensure Physician OR time is fully utilized.
When OR cases are cancelled, review open cases to identify appropriate substitutes.
Ensure patients have been cleared for surgery and are willing to change surgery dates.
Ensure authorizations are in place.
Monitor utilization and determine appropriate timing to release physician clock time, then look for Division and Department opportunities to fill slots.
Perform other duties as assigned.