Surgical Scheduler

Summary The Surgical Scheduler uses various resources to coordinate the scheduling of surgical cases for all surgical patients within St. Mary’s Regional Medical Center Specialty Practices (General Surgery, Urology, ENT, and GYN) and shares information with appropriate personnel to ensure the smooth processing of patients through the surgical process. Essential Duties and Responsibilities

Supports and promotes the mission and values of Covenant Health Ministry.

Contact insurance companies to be sure that Pre-Certification is initiated for all procedures requiring authorization or pre-certification (insurance benefit/verification can be obtained at the same time)

Documents thoroughly, within the record notes about the pre-certification process.

A copy of the insurance verification/pre-cert sheet will be filed within the patient account and given to the Patient Representative.

Updates any discrepancies found when verifying patient benefits with insurance companies.

Responsible to sort accounts based on protocol set in department for workflow and preregistration process.

Scheduling of all patients into CWS in order to provide and meet the needs of patients and physician practices.

Provides accurate, updated schedules for ancillary departments.

Provides accurate scheduling, demographic data and financial data to support the pre-cert process.

Maintains CWS dictionaries, adding and updating procedures, rooms, and new services.

Changes and maintains schedule, adjusting to meet the needs of departments.

Maintains confidentiality, personal and financial always.

Review all documentation for completeness to achieve optimal reimbursement within established guidelines.

Assigns appropriate diagnostic codes using International Classification of Disease System (ICD-9) for all admissions, through knowledge base of proper hospital admission coding.

Assign the same ICD-9 codes on an ongoing basis during MDS 2.0 data entry.

Serves as first-line quality control when reviewing MDS 2.0 and clinical record.

Audits new codes.

Maintains a log of coding changes as required by Medicare for billing rejections due to coding errors.

Works collaboratively with the Business Office to resolve concerns that affect reimbursement.

Assures completeness of abstracted information to provide database coding integrity.

Maintains knowledge of our patient coding for patient transfer to outpatient procedures (lab, x-ray, etc.).

Ensures data integrity by abstracting and reviewing data in assigning accurate ICD-9 codes.

Communicate with appropriate staff/providers to verify data/question coding or seek additional information.

Identifies deficiencies and discrepancies in MDS 2.0 to prevent financial loss to the facility.

Submits electronic mailing of MDS 2.0, Entry, and Discharge forms weekly.

Generates reports from the submissions and forwards them to Nursing Administration/Clinical Coordinators.

Mails all physician telephone orders and distributes signed orders to units.

Prints CMS Quality Indicators monthly and forwards to designated staff.

Sends weekly MDS report of assessments due.

Maintains all required competencies and completes annual compliance courses on time.

Other duties as consistent with this role.

Job Requirements

Job Knowledge and Skills

Strong computer skills.

Strong verbal and written communication skills.

Strong interpersonal skills.

Strong organizational skills.

Attention to detail is a must.

Ability to handle multiple priorities.

Education and Experience

High school diploma or GED.

Medical Terminology knowledge required.

Experience scheduling for surgical procedures or in a related medical field preferred.

An equivalent combination of education and experience which provides proficiency in the areas of responsibility listed above may be substituted for the above education and experience requirements.

Working Conditions/Physical Demands

Must p ossess the physical and mental abilities to perform the tasks normally associated with this position that involve a combination of sitting, standing, walking, bending, stooping, twisting, and reaching. Lifting/carrying frequently up to 35 pounds, and occasionally up to 50 pounds. Some stress is related to a high level of responsibility for quality care. The ability to speak, read, write, and understand written instructions in English is required.

Americans with Disabilities Statement

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.