Orthopedic Specialist- Methodist Surgery Administration

3 weeks ago


Peoria, United States Carle Foundation Hospital Full time

* Identifies all Carle Health patients that require insurance verification and prior authorization and have a sound knowledge base for the pre-surgical process.
* Proactively identifies all Carle Health patients coming in to see Orthopedic surgeons
* Coordinates with registration sources and the patient to get current insurance information.
* Researches and understands patient insurance benefits to facilitate appropriate facility requirements for care
* Follows procedures for potential keeping care in system opportunities
* Demonstrates the ability to accurately and tactfully relay any pertinent benefit or certification information to staff, providers, patient and/or patient's family.
* Collaborates and seeks assistance and direction from lead clinical position to assist in providing clinical support for insurers as indicated
* Displays sound knowledge of medical terminology and various procedures, testing and class requirements
* Communicates effectively via phone, fax and correspondence processes with multiple service providers such Primary Care Providers, specialist offices, providers, staff and patients.
* Able to multi-task and problem solveAdheres to various scripting used for various audiences
* Adapts the communication style to each patient's ability to understand
* Recognizes and responds to verbal and non-verbal communication
* Displays strong grammar skills related to composition, spelling, punctuation, sentence structure
* Outstanding telephone etiquette
* Effectively work with team, provider and clinic/hospital staff
* Works with a sense of urgency, customer service focus
* Able to schedule several appointments in a time-sensitive order, collaborating with multiple offices
* Effectively educate patient on the importance of maintaining appointments and schedules
* Collaborates effectively as a liaison between specialists, providers, staff and UPH hospital resources
* Demonstrates ability to use scheduling systems and displays appropriate telephone etiquette and interpersonal relationship building skills.
* Performs the scheduling function of the Medical Center by utilizing the scheduling computer software
* Facilitates the scheduling of Joint Classes with Carle Health resources
* Able to keep up-to-date with work queue and various stakeholder informed of process status
* Sends appropriate paper work to requesting services
* Consistently exhibits the ability to schedule multiple providers in a timely manner
* Consistently determines proper scheduling requirements and/or limitations according to request
* Meets all notification requirements prior to the patient's date of service
* Schedules patients accurately in a timely and polite manner to ensure customer satisfaction
* Exhibits a high level of proficiency in the use of the computerized scheduling system
* Oversee the entire pre-surgical process from beginning to end (office appt to OR scheduled)
* Demonstrates ability to work efficiently, prioritize patient care, establish positive relationships with key stakeholders, and work in a face-paced environment.
* Able to multi-task and problem solve
* Demonstrates ability to work independently with minimal supervision
* Communicates tactfully and clearly with staff, stakeholders and patients
* Adjust quickly to manage multiple priorities
* Coordinate concerns or barriers to key stakeholders quickly and efficiently

The Orthopedic Specialist is responsible for and supports the Carle Health Surgical Services team by managing the patient interaction, scheduling of pre-operative services, and coordination of care through the pre-surgical process. The scope begins with pre-operative services and the completion of the documentation and closure in the electronic medical record. This specialist is responsible for closely collaborating with several teams in the specialty office including, but not limited to prior authorization, nursing, physician and administration



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