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Description

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 for this leading academic medical center means collaboration 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?

Entity: Clinical Care Associates (CCA) - Penn Primary Care (PPC) and Penn Specialty Practices (PSP) of Penn Medicine Medical Group (PMMG)

Department: PMPH Breast Surgery

Hours: Full-Time

Summary:

+ Surgical Scheduling Specialist schedules all surgical procedures, associated pre-admission testing and assures that all of the appropriate clinical coding and insurance information is collected for the surgical procedure. Receives requests to schedule procedures from physician offices electronically or via booking slip and schedules the procedure according to established guidelines. Provides accurate and timely information so that all departments may view the schedule daily and maintains open communication with hospital departments and physician offices regarding schedule changes etc.

Responsibilities:

+ Scheduling and Pre-Registration

+ Schedules surgeries and pre-admission testing in scheduling system.

+ Answers inbound telephone calls, retrieve messages, faxes and emails in a professional, timely and efficient manner per department protocol.

+ Follows all 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 as per protocol. Enters data into appropriate fields within the scheduling system and attaches any clinical information such as a booking sheet to the case.

+ Moves/cancels visits based on physician and/or patient availability issues.

+ In addition, may coordinate additional resources such as extra staffing, equipment and supplies.

+ Confirms and coordinates the 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 on-line verification system(s) or places phone call to insurance company prior to the procedure. In addition, making sure all necessary referrals, authorizations and/or pre-certifications are in place prior to patient's scheduled appointment on emergent cases.

+ Utilizes scheduling system to prioritize workload based on service, date, and insurance company requirements.

+ Review applicable worklists within scheduling system to identify any additional information required to complete the case.

+ Educational Development

+ Must pass and stay current with all Penn Medicine’s educational requirements. Keeps current on CPT/HCPS coding methodologies to accurately identify procedure codes needing authorization.

+ Maintains working knowledge of Penn Medicine’s insurance verification tools, including insurance guidelines.

+ Understands ICD-10 coding methodologies to accurately identify diagnosis codes to support medical necessity. Maintains working knowledge of Medical Necessity requirements for commercial and governmental payers.

+ Interdepartmental and Revenue Cycle Development

+ Promote Teamwork both internally and externally across all department lines.Works in collaboration with other departmental associates as well as other hospital associates supporting their efforts though teamwork and the acceptance of additional assignments.

+ Accepts responsibility for own actions, while taking ownership of departmental outcomes.

+ Maintains a strong working relationship with physicians and departments at Penn Medicine to ensure maximum communication and coordination of service.

+ Performance Improvement

+ Supports the Performance Improvement goals of the department.

+ Collaborates with other staff, within and outside the department, to develop means of enhancing patient care and service.

+ Core Values

+ Take initiative to resolve accounts with and without supervision. Works toward department goals and visions as an individual and Team Member.

+ Maintains confidentiality of patient information in accordance with Penn Medicine Policies.Understands how applicable laws, regulations, policies and procedures impact specific job responsibilities and functions. Demonstrates actions to reasonable prevent, detect and report unethical and unlawful business practice.

+ Familiarity with the general usage and spelling for specific medical terminology. Collaborates with various areas of the Penn Medicine Team to increase cash by decreasing denials.

Education or Equivalent Experience:

+ H.S. Diploma/GED (Required)

+ Minimum two years’ hospital or physician office registration and scheduling or medically related call center (Required)

+ Work experience in the health care sector that exposes the candidate to medical terminologies, diagnostic procedures, and health care. billing and authorization (Required)

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. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Salary Range:

$17.75 - $28.33/Hourly

As part of their job offer, successful candidates are provided a specific rate, taking into consideration various factors including experience and education.

Click here (https://www.uphshrandyou.com/public/welcome) for information on UPHS’s Benefits.

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.

REQNUMBER: 301442