Surgical Scheduling Specialist - PMPH

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working at this leading academic medical center means collaborating with top clinical, technical, and business professionals across all disciplines. Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work? Summary: The Surgical Scheduling Specialist schedules all surgical procedures, associated pre‑admission testing, and ensures that all appropriate clinical coding and insurance information is collected for the surgical procedure. They receive scheduling requests from physician offices electronically or via booking slip and schedule according to established guidelines, providing accurate and timely information so departments can view the schedule daily, and maintain open communication regarding schedule changes. Scheduling and Pre‑Registration Schedules surgeries and pre‑admission testing in the scheduling system. Answers inbound telephone calls, retrieves messages, faxes, and emails in a professional, timely, and efficient manner per department protocol. Follows prescribed PennChart searches, including 3‑3 search and screening for any other Date of Service appointments. Reviews or collects demographic, insurance, and clinical information to establish completeness and accuracy of data; enters data into appropriate fields and attaches any clinical information such as a booking sheet to the case. Moves or cancels visits based on physician and/or patient availability issues. May coordinate additional resources such as extra staffing, equipment, and supplies. Confirms and coordinates scheduled surgeries the day prior to procedure. Insurance Verification and Medical Necessity Ensures all insurance information is entered correctly and is active at the time of scheduling. Utilizes online verification systems or places calls to insurance companies prior to the procedure; ensures all necessary referrals, authorizations, and pre‑certifications are in place before the patient’s appointment, especially for emergent cases. Uses the scheduling system to prioritize workload based on service, date, and insurance company requirements. Reviews applicable worklists within the scheduling system to identify any additional information required to complete the case. Educational Development Passes and stays current with all Penn Medicine educational requirements. Keeps current on CPT/HCPCS coding methodologies to identify procedure codes needing authorization. Maintains working knowledge of Penn Medicine’s insurance verification tools and guidelines. Understands ICD‑10 coding methodologies to accurately identify diagnosis codes supporting medical necessity. Maintains working knowledge of medical necessity requirements for commercial and governmental payers. Interdepartmental and Revenue Cycle Development Promotes teamwork internally and externally across department lines; collaborates with other departmental associates and hospital associates. Accepts responsibility for own actions while owning departmental outcomes. Maintains strong working relationships with physicians and departments to ensure maximum communication and coordination of service. Performance Improvement Supports departmental performance improvement goals. Collaborates with staff within and outside the department to develop means of enhancing patient care and service. Core Values Initiates resolution of accounts independently or with supervision; works toward department goals and visions as a team member. Maintains confidentiality of patient information per Penn Medicine policies; complies with applicable laws, regulations, policies, and procedures. Demonstrates actions to prevent, detect, and report unethical or unlawful business practice. Familiarity with general usage and spelling of specific medical terminology. Collaborates with various Penn Medicine teams to increase cash by decreasing denials. Credentials Certified Medical Assistant (preferred) Education or Equivalent Experience High School Diploma/GED (required) Bachelor’s Degree (preferred) We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Salary Range: $18.11 - $28.86 per hour. Successful candidates receive a specific rate based on experience and education. Live Your Life's Work We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law. #J-18808-Ljbffr Penn Medicine, University of Pennsylvania Health System