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

University of Miami•Greendale, WI

2d•Onsite

About The Position

The University of Miami, Bascom Palmer Eye Institute, has an exciting full time opportunity for a Surgery Services Representative 2 in Palm Beach Gardens, Florida. The Surgery Services Representative II is responsible for coordinating a wide range of complex surgery scheduling and registration functions that impact the patient experience, surgical volume, and revenue. Serves as a subject matter expert for the assigned surgical specialty. 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 costumer grievances. Adheres to University and unit-level policies and procedures and safeguards University assets. This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary. CORE QUALIFICATIONS Education: High School Diploma or equivalent/relevant experience, certification or license Experience: Minimum 3 years of relevant experience required Knowledge, Skills and Abilities: Learning Agility: Ability to learn new procedures, technologies, and protocols, and adapt to changing priorities and work demands. Teamwork: Ability to work collaboratively with others and contribute to a team environment. Technical Proficiency: Skilled in using office software, technology, and relevant computer applications. Communication: Strong and clear written and verbal communication skills for interacting with colleagues and stakeholders. This is a core job profile description and is not reflective of all duties that may be assigned to a specific position in each individual department. The above statements are intended to describe the general nature and primary responsibilities of this core job profile. Specific duties and tasks may vary based upon departmental needs. Other duties may be assigned to the above consistent with the knowledge, skills, and abilities required for the job. This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary. 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. Meets multiple daily deadlines. Skilled in prioritizing and organizing tasks. Manage large call volume daily 30+ calls 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. Promptly 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.

Requirements

High School Diploma or equivalent/relevant experience, certification or license
Minimum 3 years of relevant experience required
Learning Agility: Ability to learn new procedures, technologies, and protocols, and adapt to changing priorities and work demands.
Teamwork: Ability to work collaboratively with others and contribute to a team environment.
Technical Proficiency: Skilled in using office software, technology, and relevant computer applications.
Communication: Strong and clear written and verbal communication skills for interacting with colleagues and stakeholders.
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.
Meets multiple daily deadlines.
Skilled in prioritizing and organizing tasks.
Manage large call volume daily 30+ calls

Responsibilities

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 costumer grievances.
Adheres to University and unit-level policies and procedures and safeguards University assets.
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.
Promptly 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.