Surgery Pre-Visit Coordinator

Come and join our team! We are a local growing private medical practice specializing in the diagnosis and treatment of patients with diseases of the retina and vitreous. We are looking for individuals who would like to establish a career in healthcare working for a company with nationally recognized physicians. We provide on the job training giving you the ability to grow and advance your skills along with gaining innovative knowledge. Established in 1977, we have locations all over Northern California including Sacramento, Grass Valley, Roseville, Stockton, Modesto, Merced, Fairfield, Elk Grove, Folsom, Yuba City and Chico. Our physicians are nationally known, and we continue to be on the leading edge of retina care by utilizing the latest equipment and both participating in and designing new clinical trials to advance the state of care for retinal diseases. Join 200+ other team members working for our nationally recognized retina specialty practice in a fast paced, high volume medical office. The Surgery Pre-Visit (SPV) Coordinator is responsible for ensuring surgical patients are administratively, financially, and insurance cleared prior to surgery. The SPV Coordinator works closely with Surgery Scheduling, the Supervisor, patients, insurance carriers, and the ASC to identify and resolve authorization, eligibility, financial, and scheduling barriers. Responsibilities: Daily Schedule & Workflow Management · Run the Schedule report at least three times daily: upon arrival, mid-day, and again in the afternoon. · Stay at least two weeks ahead of the surgical schedule. · Stay on top of same-day and next-day emergent add-ons and prioritize time-sensitive clearance needs. · Run and work the Retro Authorization task list daily, at minimum twice weekly. · Follow up on pending authorizations for surgeries that have already occurred. · Prioritize MGH authorizations and ensure the Surgery Scheduler receives them or is notified when approval is obtained. Insurance Eligibility & Authorization · Verify eligibility and benefits for all surgical patients. · Verify Medi-Cal eligibility for all applicable patients on the first of every month. · Request, monitor, and follow up on prior authorizations as required. · Save approved authorizations to the Eligibility folder and into NextGen. · Document authorization information and updates in the Auth Notes within appointment details. · Request TARs and Letters of Agreement (LOAs) as necessary. · Identify insurance requirements that may require a patient to be scheduled at a different facility. · Communicate any authorization or insurance barriers that could delay surgery as soon as they are identified. Patient Financial Communication · Calculate each patient's anticipated out-of-pocket (OOP) expense and communicate the amount at least two weeks prior to surgery. · Inform patients of applicable Self-Pay rates. · Complete the required Good Faith Estimate (GFE) form. · Save CareCredit denials, when applicable. · Develop and document payment plans with patients as necessary. · Communicate financial expectations clearly, professionally, and accurately. Claims & Financial Follow-Up · Follow up on unpaid claims identified through emails from billing supervisor. · Monitor outstanding financial or authorization issues and take appropriate action to prevent delays. Communication & Team Collaboration · Communicate clearly and proactively with the Surgery Scheduling team regarding potential authorization barriers, delays, insurance restrictions, facility requirements, and any issue that could delay surgery. · Communicate with the Surgery Scheduling Supervisor regarding barriers, concerns, or operational issues that prevent completion of assigned responsibilities or impact success in the SPV role. · Before planned time off, provide a complete hand-off and status update to the Supervisor or designated SPV coverage, including outstanding authorizations, pending financial items, urgent cases, and other time-sensitive issues. · Maintain professional, timely, and solution-oriented communication with patients, physicians, staff, insurance companies, and external partners. ASC Requirements & Documentation · Complete BIFs (Billing Information Forms) daily and send them to the ASC. · Ensure authorization, eligibility, financial, and supporting documentation is accurately entered, saved, and readily accessible in the appropriate systems and folders. Performance Expectations · Proactively manage the surgical schedule rather than reacting to issues. · Maintain accurate and timely documentation. · Identify potential barriers before they become delays. · Meet established timelines and daily workflow requirements. · Communicate issues promptly and escalate concerns appropriately. · Maintain consistent follow-through on outstanding tasks. · Work collaboratively with Surgery Scheduling and the ASC to support a smooth and efficient surgical process. Disclaimer: These tasks may change based on the needs of the department, including assisting with other surgery-related administrative tasks as needed.