The Surgery Scheduler in the Center for Women's Health is responsible for scheduling and coordinating all surgeries and L&D procedure requests. This position serves as liaison and information resource for physicians, clinical support staff, Perioperative Services and patients.

Key Responsibilities & Performance Standards

 

OR surgery scheduling/care coordination for SOR, CHH, DCH

• Receive surgery requests (Consult to OR) via Epic work queues
• Schedule pre-op/post-op, Pre-Medicine Clinic and pre-surgery COVID test appointments
• Communicate surgery logistics to patients via phone/MyChart
• Submit surgery case to OR scheduling department via Epic
• Monitor SOR, CHH and DCH grids to maintain accurate, up-to-date Outlook calendars for each department
• Notify external vendors and OR schedulers to ensure that all necessary equipment is availability
• Coordinate with OHSU co-surgeons and their practice surgery schedulers and other internal and external care providers/departments as needed for medical clearance prior to surgery and postoperative care following surgery
• Communicate and coordinate with CWH/OHSU social workers, caregivers, residential facility staff, etc. to arrange for medical transportation to surgery and related appointments and ensure appropriate lodging/RPV accommodations have been made
• Ensure that the appropriate medical orders are in place for surgery-related care (imaging, lab work, referrals, etc.)
• Ensure that all medical records are in place as requested by surgeon and obtain medical records, as needed
• Document all information and/or any surgery-specific changes/updates in Consult to OR referral notes
• Educate and communicate with patient and clinic staff regarding current CWH and OHSU policies related to surgery
• Manage, release, and transfer OR blocks and add-on requests via iQueue and Epic
• Apply problem solving and negotiating skills in resolving provider and patient concerns and other surgery related problems

Managed care for surgical cases:

• Complete insurance benefit checks for each surgery case
• Maintain working knowledge of diagnostic and procedural coding appropriate for the service area to provide accurate CPT and ICD-10 codes for benefit checks and prior authorization requests
• Maintain working knowledge of Oregon Health Authority Prioritized List and Medicare Inpatient Only List
• Obtain prior authorizations, as needed, by providing relevant clinical documentation and communicating with insurance companies for any follow-up information and status updates
• Communicate all necessary insurance and/or payment information to patients prior to moderate sedation, self-pay and/or flat-fee cases, and any other surgery cases, as needed
• Communicate with referring providers, primary care providers and/or co-surgeons, as needed, for insurance authorization purposes
• Investigate and process appeal requests for insurance prior authorization denials, coordinate peer-to-peer phone calls, obtain surgeon letters of medical necessity, additional medical records as requested by insurance companies and educate patients and surgeons on appeals process
• Submit cost estimate requests to Patient Estimates Department, upon request
• Enroll patients in RH program, as needed
• Investigate surgery claim denials from No-Auth Work Queue and process claim appeals, as needed
• Initiate OHSU Financial Assistance exception requests on patient’s behalf, as needed
• Educate patients, clinic staff and surgeons regarding insurance coverage, payment information, prior authorization and appeals processes

Moderate sedation case scheduling and managed care:

• Receive moderate sedation case requests (Consult to OR) via Epic work queues
• Communicate with CWH care coordinators to ensure that patients are scheduled appropriately
• Manage/update Moderate Sedation Outlook calendar with scheduling changes
• Complete benefit checks and obtain prior authorizations, as needed
• Provide cost estimate statements and/or payment information to patients upon request

L&D scheduling and managed care:

• Receive surgery requests (Consult to OR) via Epic work queues
• Schedule elective induction of labor, cesarean sections, cesarean-hysterectomy, cerclage placements, cephalic versions in L&D
• Complete benefit checks and obtain prior authorizations, as needed
• Monitor L&D and SOR grids to maintain accurate, up-to-date Outlook calendars
• Schedule stress tests

Fetal department surgery scheduling and managed care:

• Receive surgery requests (Consult to OR) via Epic work queues
• Monitor L&D and SOR grids to maintain accurate, up-to-date Outlook calendars
• Complete benefit checks and obtain prior authorizations for fetal echo appointments, genetic testing and other fetal related appointments, as needed
• Investigate and process denial for fetal office visits

Other Duties:

• Back up other Surgery Schedulers.
• Maintain outlook calendar and OR blocks.
• Provide Surgery Scheduling Orientation/Education to the Residents.
• Other duties as assigned by manager.

Miscellaneous tasks:

• Complete insurance benefit check for same-day office visits and IUD appointments
• Prepare ABN forms and NCCFs and notify patients, as needed
• Notify PAS staff if/when appointments need to be rescheduled due to insurance issues and/or scheduling errors
• Share PAS expertise and disseminates information regarding surgery, moderate sedation, L&D and fetal surgery scheduling to other PAS personnel
• Maintain PAS Specialist skills in the areas of enrollment and authorization, arranged care, integrated care and telecommunications
• Provide training to new PSS employees, arrange training schedules and materials, as needed
• Create monthly surgical backlog reports for OR management for financial reports and OR block utilization
• Track surgery cases, L&D cases and moderate sedation requests for each department on a monthly basis
• Track urgent add-on cases scheduled outside of OR blocks
• Work overtime on little to no notice to address urgent surgery scheduling needs

• Two years of front-line clerical experience in a clinical setting with direct patient contact. Experience must include scheduling of appointments and may require experience obtaining managed care authorizations (dependent on position description).  Preference given to candidates with knowledge of OHSU’s PAS policies and procedures, with completed PAS training and core competencies, and with previous PAS experience

• High School Diploma
• Advanced PAS user skills as well as extensive knowledge of integrated care at OHSU
• Two years of experience working Managed Care in a clinic/hospital setting.
• Two years of experience working as a Surgery Scheduler for multiple Providers.
• One-year experience working in Women’s Health.
• Basic computer skills including word processing
• Windows applications, on-line scheduling, and a preference for data-base skills. 
• Excellent verbal and written communications skills. 
• Strong customer service orientation. 
• Demonstrated effectiveness in confrontational customer interactions
• Extremely organized and meticulously detailed. 

The Clinic is open Monday –Friday.  This is a 8 hour/day position. 

Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.