Surgical Scheduling Representative

Tenet Healthcare • Detroit, MI

6h

About The Position

Embark on a rewarding career with DMC Receiving Hospital. If you are a compassionate healthcare professional eager to contribute to patient care, this is your opportunity where your skills make a difference every day. Join us in delivering exceptional healthcare with a personal touch.
Benefits Statement
At Tenet Healthcare, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:
• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off (PTO)
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.
Note: Eligibility for benefits may vary by location and is determined by employment status
Job Summary
Under general supervision is responsible for contacting third party payers and obtaining authorizations/referrals for specialty physicians for all diagnostic testing and in-patient/out-patient surgical procedures. Interprets Managed Care contracts and other third party payer contacts in order to secure correct authorization and/or referral. Assures authorizations/referrals and re-authorizations are obtained and secured for patients.
Obtains appropriate clinical data for admission and out-patient surgery. Verifies eligibility and benefits of patient plans to assure proper processing of referrals. Informs patients of delays due to eligibility or benefit issue within forty-eight hours. Educates patients, staff and physicians on latest insurance requirements with respect to the referral process. Uses CPT and ICD-9 codes for diagnosis and procedures accurately. Boards all surgeries at appropriate facility.
Provides patients with date of procedure, when and where to report, and assures that all specialty clearances are obtained. Prepares tentative schedule for operating room twenty-four hours in advance, works with surgical department to ensure appropriate equipment is available for procedure. Compiles statistics and other required data. Confirms and reschedules patient appointments as necessary. Notifies manager with patient accounting or insurance issues as necessary.
Collaborates with the Perioperative Institute regarding testing necessary to gain clearance as well as keeps open communication regarding all patient issues with the PI and their staff. Attends mandatory training programs. May perform functions related to business activities including, but not limited to, patient appointments, registration, medical record management, cash collections, phone communications and office maintenance. Actively participates as a team member, including mentoring new employees. Performs other related duties as assigned.

Requirements

• High School diploma or equivalent.
• Two to three years of medical billing, medical records and insurance referral process experience.
• Working knowledge of medical terminology.
• Advanced knowledge of third party payer's requirements and reimbursement.
• Working knowledge of Michigan based Managed Care programs.

Nice To Haves

• Associate's degree in Finance, Business Administration or related field preferred.

Responsibilities

• Contacting third party payers and obtaining authorizations/referrals for specialty physicians for all diagnostic testing and in-patient/out-patient surgical procedures.
• Interpreting Managed Care contracts and other third party payer contacts in order to secure correct authorization and/or referral.
• Assuring authorizations/referrals and re-authorizations are obtained and secured for patients.
• Obtaining appropriate clinical data for admission and out-patient surgery.
• Verifying eligibility and benefits of patient plans to assure proper processing of referrals.
• Informing patients of delays due to eligibility or benefit issue within forty-eight hours.
• Educating patients, staff and physicians on latest insurance requirements with respect to the referral process.
• Using CPT and ICD-9 codes for diagnosis and procedures accurately.
• Boarding all surgeries at appropriate facility.
• Providing patients with date of procedure, when and where to report, and assures that all specialty clearances are obtained.
• Preparing tentative schedule for operating room twenty-four hours in advance, works with surgical department to ensure appropriate equipment is available for procedure.
• Compiling statistics and other required data.
• Confirming and rescheduling patient appointments as necessary.
• Notifying manager with patient accounting or insurance issues as necessary.
• Collaborating with the Perioperative Institute regarding testing necessary to gain clearance as well as keeps open communication regarding all patient issues with the PI and their staff.
• Attending mandatory training programs.
• Performing functions related to business activities including, but not limited to, patient appointments, registration, medical record management, cash collections, phone communications and office maintenance.
• Actively participating as a team member, including mentoring new employees.
• Performing other related duties as assigned.

Benefits

• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off (PTO)
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED