Surgical Scheduling & Case Management Coord - OB/GYN

Department:02250 AMG Chicago N Halsted - Obstetrics/GynecologyStatus: Full timeBenefits Eligible:YesHours Per Week:40Schedule Details/Additional Information:M-F 830am-5pm No weekends or HolidaysPay Range$21.85 - $32.80Major Responsibilities: Provides support to the physicians and patients by scheduling surgeries/special procedures in a timely efficient manner. 1)Reviews to ensure that all information on the surgical form is complete. 2)Determines that patient's insurance is eligble for appropriate facility, as well as, determining deductibles, patient's financial responsibility and medical coverage. 3)Determines and uses appropriate CPT and ICD-9 codes under the direction of the provider/surgeon. 4)Schedule surgery at appropriate location under the guidelines of the insurance company. 5)Coordinate surgical dates with patient, surgeon and primary care physician. 6)Schedules pre-operative testing with primary care physician, as well as, notifying surgeon of any abnormal results. 7)Notification to appropriate HMO/PPO sites of surgical dates, referrals, testing and surgical date changes. 8)Send completed PAT packets to surgical facilities. 9)Assist and coordinate other managed care duites/in-office surgical procedures and referral generation. 10)Produces weekly and monthly statistical reports on surgeries scheduled by appropriate facility. Case Management/Clinical Integration Process 1)To assist with the Practice Manager and/or Practice Coordinator in the case management activities, including information gathering and correspondence with patients and providers in order to facilitate quality and timely services. 2)Contacts patients and physician offices to gather needed information for clinical integration. 3)Calls physician office vendors to coordinate reimbursement of medication/supplies where it is a bill direct to insurance company and not the office. 4)Contacts hosptial affiliates in order to maintain a Milliman LOS score below 3.3 for a patient 65 and over. 5)Maintains mammogram findings within the CIRRIS system. 6)Maintains cervical screening findings within the CIRRIS system. 7)Maintains smokers findings within the CIRRIS system. 8)Request vendor and benefit exceptions from insurance companies to meet patients durable medical equipment needs. 9)Maintain, follow-up and monitor ERMA referrals within the APP system. 10)Assist with Robotic Surgery reporting as it relates to case management and residency program reporting to the State of Illinois. Communication and Education Referral Related Activities. 1)Communicates with practice manager, practice coordinator, physicians, health care professionals and ancillary staff in a positive fashion in order to promote patient satisfacation, quality services and resolution of issues. 2)Identifies and maintains appropriate communication with manager/coordinator involving problems and observations in course of daily operations. 3)Works with Advocate Medical Group in the education of physician office staff on new technology and APP criteria, as well as, CPT and ICD-9 coding for gynecology and urogynecology specialty procedures. 4)Maintains patient confidentiality and follows all HIPAA guidelings in regards to verbal communication and medical record requests. 5)Identifies surgical procedures that have not been billed in comparison to the surgical schedule and if it is in IDX/Flowcast. Education/Experience Required: Two years of college. 3-5 years experience working in healthcare with managed care and/or physician office experience. CPT & ICD9 coding experience. Case Management specialist. Knowledge of Medical Terminology. Knowledge, Skills & Abilities Required: Excellent interpersonal communication skills. Experience with IDX/Flowcast and ERMA Windows system. Excellent computer keyboard proficiency. Proficiency in all Microsoft Programs. Ability to work as a team member. Excellent organizational skills. Ability to handle difficult patient calls and maintain professional conduct. Willingness to be flexible with job responsibilities. CPR certification Physical Requirements and Working Conditions: Ability to work under stressful conditions. Ability to communicate denile of services to patients and providers. If position has direct patient care or direct patient contact the following lifting requirement supersedes any previous lifting requirement effective 06/01/2015. Ability to lift up to 35 pounds without assistance. For patient lifts of over 35 pounds, or when patient is unable to assist with the lift, patient handling equipment is expected to be used, with at least one other associate, when available. Unique patient lifting/movement situations will be assessed on a case-by-case basis. Addendum: Coordinates initial referral and precertification of surgical procedures under the supervision of the Medical Director/Physicians. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.Our Commitment to You:Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:CompensationBase compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or trainingPremium pay such as shift, on call, and more based on a teammate's jobIncentive pay for select positionsOpportunity for annual increases based on performanceBenefits and morePaid Time Off programsHealth and welfare benefits such as medical, dental