SURGICAL SCHEDULER & INSURANCE COORDINATOR

Riverside Healthcare is seeking an organized and detail-oriented Surgical Scheduler & Insurance Coordinator to join our Orthopedic outpatient department in Kankakee, Illinois. This role is critical in ensuring seamless coordination of surgical procedures and managing insurance-related processes for our patients. The ideal candidate will have experience in healthcare scheduling, insurance verification, and patient communication, with a strong focus on accuracy and customer service. This position requires excellent organizational skills and the ability to work closely with surgeons, patients, and insurance companies to facilitate efficient surgical planning and insurance approvals. Additionally, this position requires flexibility with assignments within professional scope/duties/licensure. 

Essential Duties

Surgical Scheduling:

• Coordinate and schedule surgeries and related procedures for orthopedic patients, ensuring availability of surgical staff, operating rooms, and necessary equipment.
• Confirm surgery dates, times, and preoperative instructions with patients, ensuring they have all necessary information for a successful procedure.
• Work closely with surgeons, anesthesiologists, and other medical staff to align schedules and accommodate any special requirements or changes.

Insurance Coordination & Verification:

• Verify patient insurance coverage and benefits for planned surgical procedures, including preauthorization and precertification processes.
• Communicate with insurance companies to obtain necessary approvals and ensure coverage for surgical procedures.
• Educate patients on their insurance benefits, out-of-pocket costs, and any financial responsibilities associated with their surgery.

Patient Communication & Preparation:

• Provide patients with detailed preoperative and postoperative instructions, ensuring they understand the process and what to expect.
• Coordinate preoperative testing and consultations, including lab work, imaging, and other assessments required prior to surgery.
• Address patient questions and concerns regarding their surgery, insurance, and financial obligations, providing clear and compassionate guidance.

Documentation & Record Keeping:

• Accurately enter and update patient information, surgical schedules, and insurance details in the electronic medical records (EMR) system.
• Maintain organized records of insurance verifications, authorizations, and communications with insurance companies.

Collaboration & Communication:

• Work closely with the orthopedic team, including surgeons, nurses, and administrative staff, to ensure smooth surgical scheduling and patient care.
• Communicate effectively with patients, families, insurance providers, and healthcare team members to facilitate a seamless patient experience.

Non-essential Duties

• Assist with general administrative duties within the orthopedic department, including answering phones, handling patient inquiries, and managing correspondence.
• Participate in departmental meetings and contribute to process improvement initiatives related to surgical scheduling and insurance coordination.
• Stay informed about changes in insurance policies, surgical protocols, and best practices through continuing education and training

Required Experience

• A minimum of 2 years of experience in surgical scheduling, insurance coordination, or a similar role in a healthcare setting is required.

Preferred Experience

• Experience in an orthopedic or surgical specialty is strongly preferred.
• Strong knowledge of medical terminology, insurance processes, and surgical procedures.
• Excellent organizational and multitasking skills, with a keen attention to detail.
• Exceptional communication and interpersonal skills, with the ability to provide patient-centered care and education.
• Proficiency in electronic medical records (EMR) systems, scheduling software, and related technology.
• Ability to work independently and collaboratively in a fast-paced environment.

Required Licensure/Education

• High school diploma or equivalent is required

Preferred Education

• Associates degree in healthcare administration, medical billing, or a related field is preferred.
• Certified Coder (CPC, CCS, or equivalent) is preferred.

Employee Health Requirements

Exposure/Sensory Requirements

Exposure to:  

• Chemicals: Copy machine toner, fax machine toner, household cleaners.  
• Video Display Terminals: Extreme  
• Blood and Body Fluids: Some potential due to vomit, coughing, but the use of Universal Precautions and protection reduces risk.  
• TB or Airborne Pathogens: Exposure to patients.  

Sensory requirements (speech, vision, smell, hearing, touch):

• Speech: Needed for presentations/training, telephone communication, facilitate meetings.  
• Vision: Needed to read memos and literature.  
• Smell: Electrical/fire safety.  
• Hearing: Needed for telephone communications, meetings, and listening to employee concerns.  
• Touch: Need to write, do computer entry, filing.  

Activity/Lifting Requirements   

Percentage of time during the normal workday the employee is required to:

• Sit: 80%  
• Twist: 0%  
• Stand: 10%  
• Crawl: 0%  
• Walk: 5%  
• Kneel: 0%  
• Lift: 2%  
• Drive: 0%  
• Squat: 1%  
• Climb: 0%  
• Bend: 2%  
• Reach above shoulders: 1%  

The weight required to be lifted each normal workday according to the continuum described below:

• Up to 10 lbs: Occasionally  
• Up to 20 lbs: Occasionally  
• Up to 35 lbs: Occasionally  
• Up to 50 lbs: Not Required  
• Up to 75 lbs: Not Required  
• Up to 100 lbs: Not Required  
• Over 100 lbs: Not Required  

Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.): Carry charts from file cabinets to exam room or desk; stock rooms with supplies, carry supplies from med room to patient room. Place supplies in cabinets, move chairs and boxes.  

Maximum consecutive time (minutes) during the normal workday for each activity:

• Sit: 10  
• Twist: 1  
• Stand: 10  
• Crawl: 0  
• Walk: 3  
• Kneel: 0  
• Lift: 1  
• Drive: 0  
• Squat: 1  
• Climb: 0  
• Bend: 1  
• Reach above shoulders: 2  

Repetitive use of hands (Frequency indicated): 

• Simple grasp up to 15 lbs.  
• Pushing &pulling Normal weight: 5-100 
• Fine Manipulation: Writing, calculator, and computer keyboard.  

Repetitive use of foot or feet in operating machine control: Not Required 

Environmental Factors &Special Hazards

• Environmental Factors (Time Spent):  
• Inside hours: 8  
• Outside hours : 0  
• Temperature: Normal Range  
• Lighting: Average  
• Noise levels: Average 
• Humidity: Normal Range  
• Atmosphere: Odors  
• Special Hazards:  
• Protective Clothing Required: None