UC Health, LLC
Physician Services Specialist- Ortho (Finance)
Must have vast knowledge of medical terminology for accuracy in chart review. attention to detail, ability to navigate the medical record, great organization, excellent customer service, and self-starting.Administration:
• Answers telephone and direct to correct person if needed.
• Manages Outlook Calendar for providers within the clinic.
• Manages office incoming mail.
• Manages incoming communication related to case authorization.
• Validates registration information with patients and verifies all third-party payors (i.e. BWC, accident insurance, etc).
• Engages in population appropriate communication.
• Gives clear instructions to patients/family regarding treatment, diagnostic, procedural or surgical plan as directed by clinical team.
• Monitors and coordinates timely follow up for planned diagnostic procedure based upon the standard of care.
• Prepares for upcoming clinics related to procedural planning.
• Coordinate clinic template changes required to meet case and procedural obligations.
• Coordinates provider calendar related to faculty obligations.
• Performs in-basket management tasks.
• Coordinates completion of FMLA, Disability, BWC forms.
Scheduling:
• Schedules and coordinates patient services, surgeries, tests, and other procedures as needed.
• Coordinates all pre-procedural testing, diagnostic studies, medications, and other services as needed.
• Communicates with patients via phone and in person regarding scheduling related matters.
• Manages OR block time with providers Outlook calendar if applicable based on department guidelines.
• Reviews and coordinate case changes identified with leadership related to urgency, case order, or unforeseen delays.
• Helps review daily schedules as needed and make leadership aware if changes are needed or discrepancies are identified.
• Liaisons between staff and procedural areas for scheduling needs
• Coordinates with all product or device representatives for cases
• Completes complex coordination with co-surgeons in other surgical practices for joint case authorization and scheduling.
• Completes case request and referral order entry.
Data Management:
• Performs audits on patient records/registration for insurance billing and compliance.
• Reviews of office notes to ensure that all required items are noted for authorization request.
• Performs pre-authorizations and pre-certifications utilizing care management protocols.
• Utilizes payer portals to complete case, procedure, and visit authorizations.
• Coordinates peer to peer reviews for pending case authorization.
• Obtains CPT codes for all surgical and procedural cases and submit for authorization.
• Obtains retro authorizations as needed.
• Coordinates with utilization review for authorization status to avoid financial risk
• Updates documentation in referral tab with all authorization updates
Other duties as assignedAdministration:
• Answers telephone and direct to correct person if needed.
• Manages Outlook Calendar for providers within the clinic.
• Manages office incoming mail.
• Manages incoming communication related to case authorization.
• Validates registration information with patients and verifies all third-party payors (i.e. BWC, accident insurance, etc).
• Engages in population appropriate communication.
• Gives clear instructions to patients/family regarding treatment, diagnostic, procedural or surgical plan as directed by clinical team.
• Monitors and coordinates timely follow up for planned diagnostic procedure based upon the standard of care.
• Prepares for upcoming clinics related to procedural planning.
• Coordinate clinic template changes required to meet case and procedural obligations.
• Coordinates provider calendar related to faculty obligations.
• Performs in-basket management tasks.
• Coordinates completion of FMLA, Disability, BWC forms.
Scheduling:
• Schedules and coordinates patient services, surgeries, tests, and other procedures as needed.
• Coordinates all pre-procedural testing, diagnostic studies, medications, and other services as needed.
• Communicates with patients via phone and in person regarding scheduling related matters.
• Manages OR block time with providers Outlook calendar if applicable based on department guidelines.
• Reviews and coordinate case changes identified with leadership related to urgency, case order, or unforeseen delays.
• Helps review daily schedules as needed and make leadership aware if changes are needed or discrepancies are identified.
• Liaisons between staff and procedural areas for scheduling needs
• Coordinates with all product or device representatives for cases
• Completes complex coordination with co-surgeons in other surgical practices for joint case authorization and scheduling.
• Completes case request and referral order entry.
Data Management:
• Performs audits on patient records/registration for insurance billing and compliance.
• Reviews of office notes to ensure that all required items are noted for authorization request.
• Performs pre-authorizations and pre-certifications utilizing care management protocols.
• Utilizes payer portals to complete case, procedure, and visit authorizations.
• Coordinates peer to peer reviews for pending case authorization.
• Obtains CPT codes for all surgical and procedural cases and submit for authorization.
• Obtains retro authorizations as needed.
• Coordinates with utilization review for authorization status to avoid financial risk
• Updates documentation in referral tab with all authorization updates
Other duties as assigned