Job Details

Job: Surgery Scheduling & Authorization Coordinator
Classification: Hourly/Non-Exempt
Job Category: Administrative Support Workers

Position Summary
The Surgery Scheduling & Authorization Coordinator is responsible for scheduling hospital-based procedures and coordinating all aspects of insurance verification and authorization prior to patient services. This dual-role position ensures all scheduled procedures align with hospital policy, the patient's diagnosis, and physician orders, while also verifying eligibility, obtaining pre-certifications, and managing authorization requirements.

Essential Functions
Scheduling Responsibilities
-Schedules hospital-based procedures, surgeries, and diagnostic tests in accordance with patient diagnosis and physician requests.
-Coordinate with physicians, department staff, and vendors to ensure appropriate resources, equipment, and time/location slots are secured.
-Inputs notes and special scheduling instructions into the electronic medical record (EPIC).
-Coordinates multidisciplinary procedures with departments such as EEG, Radiology, Cardiac Rehab, and Pediatric Clinic.
-Prepares and distributes daily operating schedules and weekend call schedules to appropriate personnel.
-Maintains physician privileges records and coordinates with the Medical Staff Coordinator for updates and new physician procedures.
-Assists team members and performs additional scheduling tasks as assigned.

Authorization Responsibilities
-Reviews patient demographic, insurance, and billing data for accuracy and completeness.
-Verifies insurance eligibility and obtains necessary prior authorizations or pre-certifications.
-Navigates payer websites and utilize payer-specific guidelines to assess medical necessity based on diagnosis, history, and treatment plans.
-Submits timely referrals, notifications, and clinical documentation to secure authorization and minimize delays in patient care.
-Communicates policy coverage and benefits to patients clearly and professionally.
-Assists in denial management by ensuring compliance with payer guidelines to reduce financial penalties.
-Responds to phone inquiries and written correspondence related to patient accounts and authorizations.
-Maintains composure under pressure and use sound judgment in problem-solving.

Additional Responsibilities
-Must adhere to and follow all patient experience initiatives.
-Must comply with TRMC vaccine policy(s) as mandated by the Centers for Medicare & Medicaid Services (CMS).
-Demonstrated ability to work independently and collaboratively in a fast-paced healthcare environment.
-Strong communication, organizational, and problem-solving skills required.

Work Experience
-One to three years of healthcare experience in scheduling, billing, or authorization required or equivalent education and experience.
-Familiarity with EPIC electronic health record system preferred.

Education
-Associate's degree in related field preferred.
- Completion of a medical terminology course or equivalent preferred.

Physical Demands and Work Environment
Lifting/Carrying Pushing/Pulling
Lbs. % Time Lbs. % Time
1-10 34-66 1-10 34-66
11-20 0-33 11-20 0-33
21-50 0-33 21-50 0-33
51-75 0-33 51-75 0-33
76-100 None 76-100 None

Movement % Time
Bend/Stoop/Twist 0-33
Crouch/Squat 0-33
Kneel/Crawl 0-33
Reach above Shoulder 0-33
Reach below Shoulder 0-33
Repetitive Hand 0-33
Grasping 0-33
Squeezing 0-33
Climb Stairs 0-33
Walking Uneven 0-33
Walking Even 34-66

Environment % Time
Indoors 67-100
Outdoors 0-33
Extreme Heat None
Dusty None
Excessive Noise 0-33

Equipment % Time
Motor Vehicles None
Foot Pedals None
Extreme Heat None
Dusty None
Excessive Noise 0-33

Work near % Time
Machinery None
Electricity None
Sharps 0-33
Chemicals 0-33
Fumes 0-33
Heights None

Vision
Depth Perception Required
< 20" Required
Color Not Required
Peripheral Required

Endurance Hours at Once Total in 12HR
Sit 1 3
Stand 4 4.5
Walk 4 4.5