• Communicate clearly and openly
• Build relationships to promote a collaborative environment
• Be accountable for your performance
• Always look for ways to improve the patient experience
• Take initiative for your professional growth
• Be engaged and eager to build a winning team
• Reviews patient registration to ensure it is complete
• Verifies all insurance and notes it in Practice Management System/EMR.
• Responsible for maintaining surgery criteria current with insurance providers and informing staff of any changes/updates.
• Communicate to patients and coworkers in a professional, enthusiastic, friendly and positive manner.
• Initiates patient into surgery pipeline, serves as advocate for patient and schedules initial consultation with surgeon.
• Communicates insurance benefits, deductibles, coinsurance, financial responsibilities and any additional medical testing/screening to patients.
• Secures Pre-determinations & Pre-Certifications for all procedures as well as any general surgery.
• Handle physician referrals to practice ensuring that doctor’s info is in the practice management system/EMR.
• Referral is acknowledged and notified that patient is verified, assigned, contacted and initiated into surgery process.
• Prepare and submit Letters of Medical Necessity and ensure that all insurance criteria & medical clearances have been completed.
• Upon insurance approval, communicates approval to patient, collects financial fees due, schedules pre op consultation, advises patient of surgery date and schedules 1 week post op appointment.
• Handle all appeals and denials in conjunction with patient’s care.
• Participate in patient education seminars or meet the doctor events with other members of practice staff, educating interested parties about the surgery program.
• Prepare physical space for seminars/events.
• Assist other staff members to deliver the highest quality of patient care which includes being a team player to execute not only your duties but those that are needed by the practice when necessary.