Surgery Processor

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:

1. Registers Inpatient & Outpatient Surgery and 24 Hour Observation patients.
   1. Obtains information required for verification of insurance, workers’ compensation, Medicare, MediCal, or any other third party payer.
   2. Obtains necessary signatures on registration forms. 
   3. Verifies insurance benefits and obtains authorization for scheduled procedures.
   4. 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.  
   5. Requests copies of TARs from Physicians’ offices and reviews information on the TARs for accuracy.
   6. Reports to review organization upon admission and or pre-admissions in a timely manner for hospital notification 
   7. Assists the Anesthesiologist in obtaining billing information.
2. 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.
3. 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.
4. 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.  
5. 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.
6. 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.
7. 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.
8. Performs general clerical functions:  answers telephones, types, compiles necessary reports and maintains filing systems for information needed to complete work within the department.    
9. Coordinates patients on Pre-surgical instructions and arrival times.

OTHER RESPONSIBILITIES:

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

SUPERVISORY RESPONSIBILITIES: none

EDUCATION, KNOWLEDGE, SKILLS, ABILITIES, AND EXPERIENCE: 

1. High school education or equivalent experience.   Experience in a patient registration, medical office or health insurance environment.
2. Mathematical ability required to review statistical data on various financial records.
3. Strong clerical background is necessary, 10 key adding machine, typing experience, and computer friendliness is required.  
4. Understanding and ability to apply medical terminology. 
5. 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: