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Position Highlights
Position Summary
Under General Supervision:
The Billing Surgery Scheduler schedules patient procedures at the Hospital or other facilities as directed, and assures that all of the appropriate clinical and insurance coding information is collected for the surgical schedule. The scheduler schedules the surgical procedure according to the available templates specified per provider and location and maintains open communications with the staff at the hospital and surgical centers, along with the physicians.
The Billing Surgery Scheduler also reviews in Epic the professional charges entered by providers to ensure that charges are accurate from a correct coding perspective. The scheduler accurately codes and enters all surgical case procedures performed by physicians and corrects errors in coding and claims in applicable Epic workqueues.
Essential Duties & Responsibilities
Schedule Surgical Procedures using EPIC EHR
Order preoperative testing and labs (as certification and Epic access allows)
Provide patient with specific instructions for preoperative testing and date of procedure
As knowledge base and credential allows, answer procedure related inquiries and maintain a polite, respectful attitude towards patients and their families
Verify insurance information in order for prior authorization to be obtained, and follow up to make certain prior authorization is in place prior to procedure.
Assure appropriate coordination with the surgical department when procedures warrant outside representatives from companies to be present during procedure
Must be organized and detail oriented to keep track of various schedules
Basic knowledge of Medical terminology for the surgical procedures that physicians perform
Perform any related tasks as delegated by Physicians or Manager
Review and complete any Billing related requests
Review charges entered by providers and make certain appropriate codes are in place, including accurately entering all coding for surgery/procedures performed by physicians
Complete insurance referrals and authorizations for diagnostic imaging orders in the EHR according to established procedures as requested by patients and approved by providers
Perform pre-certifications and prior authorizations as needed.
Track referral and authorization/precertification for imaging orders and comment over its status
Follow up to obtain the referral or authorizations for imaging reports in a timely manner
Manage and address appropriately telephone encounters assigned to the Epic “Billing/Referral Coordinator inbox”
Manage requests for medical records following HIPAA compliant procedures
Review providers entered charges and billing for appropriate coding prior to release to the central billing team for claim processing
Perform any related tasks as delegated by the Billing Manager/Practice Manager
Other job related duties as assigned
Adheres to all Core Values (Compassion, Pursue Excellence, Cooperation and Collaboration, Upholds Honesty, and Supports Innovation).
Adheres to all Absolutes (Privacy and Confidentiality, Professional Appearance, and Responsibility and Commitment).
Minimum Qualifications
High School Diploma or Equivalent
Moderate Computer Skills
Medical Terminology background
Preferred Qualifications:
Certified Medical Assistant
Certified Professional Coder
Previous Medical Office Experience, Experience with electronic medical records.
Comprehensive Benefits Offered
About Middlesex Health
The Smarter Choice for your Career!
Come join one of Connecticut’s Top Workplaces, and a Magnet designated organization! At Middlesex Health, we have a unique combination of award-winning talent, world-class technology, and patient-first care that's making health care better. Through our affiliation with the Mayo Clinic Care Network, Middlesex Health has access to the most advanced medical knowledge and research available.
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