Surgery Scheduler / Prior Authorizations

Roseville

Posted 3 years ago

Minnesota Epilepsy Group is the largest and most comprehensive adult and pediatric epilepsy program in the Midwest. As a regional referral facility, we are the recognized leader in treating epilepsy and other seizure-related conditions in infants to the elderly. We are a national, state-of-the-art, Level 4 epilepsy center committed to enhancing each patient’s quality of life and maximizing seizure control.

The main job function will be surgery scheduling along with other specialty scheduling for the clinic. You will be responsible for working with the insurance companies to get certifications, pre-authorizations, updates and will coordinate the appeals process as necessary for a variety of services MN Epilepsy Group offers. Collaborating with both adult and pediatric physicians, billing department, and front desk staff to ensure a friendly, safe and customer service-oriented environment for patients, their families and/or caregivers.

Major Duties and Responsibilities:

Responsible for scheduling surgical procedures, diagnostic procedures, inpatient stays, and outpatient procedures.
Obtain certifications and pre-authorizations for surgical procedures, diagnostic procedures, inpatient stays, and outpatient procedures.
Work in collaboration with physicians and staff within and outside of MN Epilepsy Group to coordinate surgery admissions, diagnostic testing, inpatient admissions and care for pediatric and adult patients.
Participate in weekly surgical conferences.
Write a variety of letters to insurance on behalf of patients for example letters of appeals, medical necessity, etc.
Review written chart notes for documentation of changes of patient status, medical treatment plan and response and relay to insurance companies as necessary for updates and extension of stay requests.
Document and maintain all information gathered for admissions and surgical services.
Provide patient, families, and caregivers epilepsy education utilizing appropriate instructional strategies as appropriate for admission.
Identify problems and recommend solutions to ensure compliance with standards of clinical practice and improve internal processes.
Develop and maintain positive working relations with all MEG employees and other departments as a responsibility in fulfilling all job functions.

Position Requirements:

Strong knowledge regarding insurance, preauthorization and appeals process for insurance preferred.
High level of proficiency relating to medical terminology and strong healthcare background.

Essential Functions:

Ability to effectively communicate in English both oral and written formats.
Strong attention to detail, organization, customer service and ability to communicate with all levels of the organization.
Strong skills in utilizing written, telephonic and online systems to obtain, verify, document and communicate referral and preauthorization information with the clinic and affiliate hospitals.
Ability to work independently and exercise good judgement as it relates to patient care issues.
Skilled in selected software programs: Word, Excel, Outlook, insurance specific websites/portals, and any other systems as necessary to function in the role.
Ability to remain calm and maintain professional behavior in stressful situations.
Ability to maintain effective working relations with varied levels of individuals. For example, a range could be a patient to referring physician.
Maintain confidentiality/privacy as described in MEG’s policies and as described by HIPPA.
Ability to bend, stoop, twist, and lean multiple times per day
Abide by security rules as defined by MEG’s policies and as described by HIPPA. This job description is not intended to be all-inclusive and may be expanded to include other duties and responsibilities that management may deem necessary from time to time.

Minnesota Epilepsy Group PA is an Equal opportunity employer.

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