Specialist, Surgery Scheduling

Job Summary:
Under indirect supervision, schedules patients for surgery according to the type of surgery (urgent or routine) and the access standards and directive of scheduling provided. The Surgery Scheduling Coordinator ensures that the surgical encounter (outpatient vs. inpatient) is coordinated properly & is scheduled accurately and efficiently. Responsible for providing the highest quality customer service to our members, TSPMG practitioners, external practitioners, and external surgical sites through coordination of multidisciplinary facets of care, both internal and external. Responsible for the management and coordination of surgical schedules, cross-specialty schedules and availability of appropriate equipment and supplies for surgical cases. Acts as a liaison and coordinates information flow between the Specialist, PCP and Hospitalists. Responsible for data processing, diagnostic reporting, clinical information gathering, verification of coverage, QRM authorization, and completion of all other pre-operative requirements to include obtaining authorization from outside insurers for Medicaid patients using their independent authorization system. Responsible to manage incoming calls, data ques and other reporting tools to update, cancel and reschedule patients for surgery. Essential Responsibilities:

• Arranges for special needs as ordered by the physician on the surgery scheduling form (ex. equipment, techs, assists, etc).
• Arranges case priority according to established guidelines for each O.R. block (example: M.D. assist cases, children and elderly, general anesthesia, and other cases.
• Receives cancellations from patients and physicians. Cancels all preoperative appointments. Follows the cancellation procedure for notifying physicians and appropriate departments.
• Schedules cases to fill cancellations for maximum utilization of surgery block.
• Contacts physicians, appropriate departments and outside hospitals or surgery centers who perform surgery to obtain and provide all pertinent information regarding scheduling of operations.
• Schedules patients for all pre-operative appointments (including Cardiology and Pulmonology clearance, pre-op education class etc.
• Negotiates surgery date and all prescribed appointments with patients so that these are accomplished within appropriate time frames. Gives patients special dietary instructions and preparations for tests.
• Mails and/or emails confirmation letter and instructions to patients in a timely manner.
• Contacts patients who no show for surgery and reschedules these appointments.
• Provides daily log of encounters worked.
• Schedules inpatient and outpatient surgical procedures.
• Uses judgment, experience, and insight to ensure that surgical cases are scheduled according to best practice standards, achieving the best possible outcome for the member. To achieve success in posting a case, must consider all aspects affecting the case i.e., surgeons time constraints and availability, surgical suite availability at multiple surgical sites, and coordination of ancillary services that may be indicated.
• Reviews surgical ticket to ensure that the surgical facility and anesthesia screening requirements are met. Must remain knowledgeable with the current anesthesia screening requirements and other written guidelines as they relate to age and existing medical conditions. Communicates the patients needs to the practitioner to ensure compliance.
• Performs pre-authorization through QRM and other systems required.
• Coordinates surgical assistance, both TSPMG practitioners, external practitioners, & various surgical assisting groups.
• Coordinates the availability of special equipment implants, vendor resources and instrumentation for the surgeon in the operating room suite.
• Coordinates joint cases with various surgical services both internal & external i.e., GYN, Urology, Vascular, Plastic, etc. - Schedules Stereotactic Biopsies, Ultrasound Guided Biopsies, and breast MRIs under the guidance of the Breast Care Coordinator and Breast Center Chief.
• Schedules sequential appointments for the member both pre and post operatively. Employs judgment and insight to ensure timeliness and coordination of the various appointments as they relate to the surgical encounter. i.e., labs, medical clearance, cardiac clearance, etc.
• Communicates with patient and coordinates all encounters that are required during the peri-operative period i.e., pre-op office appt., PCP/HCT pre-op testing appointment (either telephone vs. actual visit. Provides procedural instructions per departmental guidelines to include diet restrictions, medication restrictions and directions to the surgery site. Schedules post- operative appointment.
• Responsible for coordination of films availability at the procedure &/or surgery site, as dictated by the needs of the surgeon or site.
• Schedules cosmetic surgery patients, after business office has ensured payment.
• Responsible to ensure that correct coding is in place to achieve correct posting and billing.
• Documents all member communications in the electronic medical record.
• Cross trains to various clerical department functions.
• Answers incoming calls from a que line and fields questions when appropriate to other schedulers to ensure member resolution and scheduling timely
• Responsible to manage their voicemail daily to respond to return calls and provide appropriate feedback to members related to surgery scheduling questions
• Receive daily cancellation list and manages cancellations timely removing them from the KP system updating the surgeon and outreaching to member for cancellation reason and reschedule when appropriate.