Surgery Coordinator

The Surgery Coordinator role serves as the patient point of contact with the practice to maintain open channels of communication to keep patients engaged and maintain an efficient flow of patients from patient registration, insurance verification, initial contact and surgeon consultation through the surgical pathway to complete insurance and program criteria, and pre-determinations/authorizations to be submitted to insurance provider for approval for surgery, and throughout their process of care, while also supporting the mission and vision of the patient experience at Flagships Specialty Partners/Carolinas Centers for Oral & Facial Surgery.

Essential Duties & Responsibilities

• Manages referral communication for complex cases to provide seamless and comprehensive patient care coordination. Serves as primary point of contact for patients/families, physicians, clinical staff, other disciplines/professionals as well as community, to coordinate patient schedules, treatment programs, and recommendations for pre and post-surgical appointments and any recommended post-discharge services.
• Gathers and interprets appropriate data from the medical record, patient, and family as evidenced by documentation. Has the clinical knowledge required to identify the need to modify care and/or treatment plans according to specific patient demographics such as age and pre-existing or current health condition(s).
• Submits insurance pre-determinations, pre-certifications and appeals for major surgery cases (including any letters, x-rays, models, etc., needed). Responds to Estimate of Benefits. Communicates with patients throughout pre-determination process to keep them updated on insurance approval.
• Actively participates in patient consultations and collaborates on treatment planning surgical procedures in concert with primary provider(s). Supports risk management and participates in programs directed to patient and staff safety. Considers patient rights in performance of job duties and responsibilities.
• Contributes to the quality management process; identifies role and contributions upon request.
• Adheres to safety policies and procedures in performing job duties and responsibilities. Reports observed or suspected violations, hazards, and non-compliance according to Company policy. Responds to emergency situations with competence and composure.
• Objectively evaluates suggestions, grievances, and processes to identify opportunities to improve performance and quality of care or seeks further guidance, as needed.
• Communicates effectively and professionally using a translator when necessary.
• Maintains and promotes professional competence through continuing education and other learning experiences.
• Objectively evaluates suggestions or criticisms and attempts to improve performance or seeks further guidance as needed.
• Attends and actively participates in meetings, committees, in-services, seminars, workshops, conferences, quality management activities according to job responsibilities and Practice requirements.
• Considers priorities and special needs when scheduling appointments and procedures. Maintains schedule according to Practice policy, oral surgeon’s time, and staffing requirements and coordinates schedule assessing time and equipment availability; identifies conflicts and adjusts schedule as needed as well as notifies designated personnel of schedule changes according to Practice policy.
• Schedules appointments and surgeries with hospital, in office computer (patient scheduler and spreadsheet) and in appointment calendar, as appropriate. Assists with daily completion of appointment schedules.
• Up to 10% of role may consist of assisting in surgical procedures as needed.
• Ensures patient EMR updates are made reflecting patient and family communication regarding deficits, progress towards goals, potential treatment needed and any additional visit notes.
• Communicates with patients throughout pre-determination process to keep them updated on insurance approval.
• Completes paperwork as needed (for charts, patients, insurance companies, hospitals, etc.). Collects down payments for hospital surgeries according to Practice policy.
• Coordinates or assists with research studies or projects as needed.
• Ability to travel to other offices as needed to support program growth, participate in surgical consults/procedures and in new team establishment/development.
• Adherence to safety procedures required.

Minimum Qualifications

• Bachelors Degree in health sciences related field or high school diploma and equivalent experience in a healthcare related field
• CPR certification required
• Strong and effective communication and platform skills
• High degree of professionalism and professional image
• Positive attitude, change advocate, lead by example, coach-able
• Strong interpersonal and relationship building skills
• Strong initiative and ability to exercise sound judgment
• Exhibits good time management and project management skills
• Excellent organization and follow up skills
• Proficiency using Microsoft Office products
• Experience in a surgery facility (preferred)
• CPT & ICD-9 coding experience (preferred)