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Job Summary

The Patient Services Intermediate/Surgery Scheduler position is responsible for obtaining detailed information for all aspects of a patient’s surgery, including inpatient/outpatient surgery.  The scheduler provides quotations for patient pay procedures and obtains all necessary payer authorizations to maximize reimbursement for services rendered. This includes drafting, typing and submitting prior authorization letters using clinical notes and discussions with the surgeons.  Plastic Surgery Schedulers schedule surgeries across UH, EAA, Livonia, Mott and CVC to optimize patient service and surgeon efficiency, and also coordinates surgeries with other surgeons and services.  The Scheduler also monitors and updates information regarding current insurance data and patient demographics.    

    Responsibilities*

    The Surgery Scheduler in Plastics schedules and manages approximately 5 million dollars in RVU based revenue.

    1. Obtains all necessary payer authorizations to maximize reimbursement for services     rendered, including drafting, typing and submitting prior authorization letters using clinical notes and discussions with the surgeons.    
    2. Obtains detailed benefit information for all aspects of surgery, including inpatient/outpatient surgery.  Ensures that prior authorizations are secured prior to scheduling surgery.  PLA Surg Schedulers are expected to prevent unnecessary write-offs due to lack of contract or authorization for the institution. 
    3. Follows established guidelines for documenting insurance approvals/denials and no authorization needed utilizing MiChart Referral Entry or MiChart Imaging, as appropriate.
    4. For patients with No Fault or Worker’s Comp insurances, PLA surg schedulers are the resource for the individual claims adjusters to contact when they need updated clinical information on a patient’s progress
    5. Acts as a resource to the patient and family on insurance issues and alternative funding options, and assists with resolution of billing problems.   
    6. Works with Billing on retro-prior authorization issues, in a timely manner. 
    7. Counsels patient to contact the UM Financial Counseling Office to address questions regarding coverage, deductible, co-pay, and/or co-insurance.  Provides handout and/or business card.
    8. Monitors and updates information regarding current insurance data and patient demographics.   
    9. Prior to a patient’s surgery, if their insurance company requires pre-notification with Dates of Service and Dx codes and CPT codes, this information is faxed to Document Control Center for imaging into the patient’s medical record.
    10. Uses online insurance verifications systems such as WebDenis, Medicare HIQA, Medicaid, and MiChart CareWeb.  
    11. Must keep current on all U of M Managed Care Contracts and state and federal government policies.  
    12. Verifies that the clinical staff (nurses) has obtained all necessary medical clearances prior to surgery.   
    13. Manages surgical schedules across UH, EAA, Mott, and Livonia, to optimize patient service and surgeon efficiency.  
    14. Provides quotations for patient pay procedures.  Advises patients on reimbursement for combined cosmetic and medically necessary procedures.  
    15. MiChart Surgical Case Depot Management:  Move cases from the scheduling depot, in a timely manner, in a way that is responsive to patients and optimizes use of OR time; 90 days from date entered into Depot.
    16. Coordinates surgeries with other surgeons.  
    17. Assures that all pre and post-operative visits are scheduled.  
    18. Advises surgeon on practice patterns including when to increase number of new visits to improve the surgical schedule.
    19. Other duties as needed; Call Center, Check-out, projects.

    Required Qualifications*

    Must be detail oriented, have excellent customer service and organizational skills.  The successful candidate will have 3-4 years of medical office experience, including a working knowledge of medical terminology, diagnosis and procedure coding, and experience working with insurance referrals and authorizations.  The successful candidate will be comfortable with working directly with surgeons; will be a self-starter, motivated, and have a positive and professional attitude; will demonstrate effective verbal and written communications skills; will demonstrate the ability to work with minimal supervision, the ability to take direction and to work with others as part of a team.  High School Graduate or Equivalent.

    Desired Qualifications*

    Working knowledge of MiChart Cadence, WebDenis, E-referral, Champs, ORMIS, Outlook; financial or specific surgery scheduling background is a plus.  Bachelor’s degree preferred. 

    Background Screening

    Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings.  Background screenings are performed in compliance with the Fair Credit Report Act.

    Application Deadline

    Job openings are posted for a minimum of seven calendar days. This job may be removed from posting boards and filled anytime after the minimum posting period has ended.

    U-M EEO/AA Statement

    The University of Michigan is an equal opportunity/affirmative action employer.