Surgery Processor

Job description

SUMMARY:
The Surgery Processor pre-admits Inpatient, elective Inpatient and Outpatient Surgery, and 24 Hour Observation patients. Obtains insurance information for verification and authorization on surgery, as well as 24-hour observation patients. Interviews incoming patients or their representatives and prepares registration forms for signatures. Is responsible for patient demographic information that is accurate and complete.
ESSENTIAL FUNCTIONS :
• Registers Inpatient & Outpatient Surgery and 24 Hour Observation patients.
• Obtains information required for verification of insurance, workers’ compensation, Medicare, MediCal, or any other third party payer.
• Obtains necessary signatures on registration forms.
• Verifies insurance benefits and obtains authorization for scheduled procedures.
• Inform patients of benefits determination and their financial responsibility. Advise patients of expected deposits. Coordinates with the Financial Services department patients with problems on financial arrangements.
• Requests copies of TARs from Physicians’ offices and reviews information on the TARs for accuracy.
• Reports to review organization upon admission and or pre-admissions in a timely manner for hospital notification
• Assists the Anesthesiologist in obtaining billing information.
• Acts as back up for Insurance Verifiers in their absence or may perform other related duties within the department to facilitate workflow and to promote healthcare for our customers.
• Utilizes the HIS Affinity system to its full capacity. Makes changes in the computer on billing information as requested by Insurance Verifiers and the Department Manager.
• Keeps accurate records on all patients, under scope of responsibility, which includes keeping accurate information on account activity; provides appropriate file documentation as needed to maintain accurate records on patients’ account financial status.
• Demonstrates an understanding of Admission Policies and Procedures in performing job duties and instructing patients and hospital personnel. Routinely uses Admissions Policy and Procedure manual and other reference materials.
• Provides quality control feedback as it relates to the quality, accuracy, and timeliness of other departments as it relates to the admission and billing process.
• Responsible for reporting the status of all accounts under scope of responsibility. This includes the timely response to all requests and inquiries by the Department Coordinators or Manager.
• Performs general clerical functions: answers telephones, types, compiles necessary reports and maintains filing systems for information needed to complete work within the department.
• Coordinates patients on Pre-surgical instructions and arrival times.

OTHER RESPONSIBILITIES :
• Customer Service: Promotes a positive patient experience, interfacility as well towards interdepartmental relation in a caring environment
• Is responsible for maintaining confidentiality of patients, services rendered and financial or demographic information.
• Balances cash drawers, accepts payments, and generates receipts for patients & guarantors.
• Performs similar job related duties as assigned.

SUPERVISORY RESPONSIBILITIES: none
EDUCATION, KNOWLEDGE, SKILLS, ABILITIES, AND EXPERIENCE:
• High school education or equivalent experience. Experience in a patient registration, medical office or health insurance environment.
• Mathematical ability required to review statistical data on various financial records.
• Strong clerical background is necessary, 10 key adding machine, typing experience, and computer friendliness is required.
• Understanding and ability to apply medical terminology.
• Bilingual (English/Spanish)

LICENSES AND CERTIFICATIONS: none
AGE OF POPULATION SERVED :
Newborn  Infant/Pediatric  Adolescent  Adult  Geriatric  All X No Patient Care X
PHYSICAL REQUIREMENTS :
• Sits, stands, bends, lifts, and moves intermittently during working hours. Visual and hearing acuity pertinent to communicating with customers.