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. Minimum of 1 year of medical receptionist, medical scheduling, or clinic experience required. Ability to organize, prioritize, and manage multiple tasks in a fast-paced environment. Strong attention to detail and ability to proactively identify potential scheduling issues before they affect patient care or the surgical schedule. Ability to understand surgical diagnoses, procedure urgency, and appropriate scheduling timeframes. Ability to look ahead and manage the schedule proactively rather than reactively. Strong verbal and written communication skills. Excellent patient service and telephone communication skills. Ability to clearly communicate scheduling processes, requirements, and issues to patients, physicians, clinics, and surgical facilities. Ability to establish and maintain positive working relationships with physicians, clinic staff, surgical facilities, and team members. Ability to review clinical plans and documentation to identify information pertinent to surgery. Resourceful problem-solving skills and the ability to utilize available resources to obtain answers and resolve issues. Ability to maintain confidentiality and handle sensitive patient information appropriately. Strong organizational and time-management skills.

Requirements:

Proficiency in electronic medical record systems, including NextGen. Ability to navigate payer and insurance websites. Working knowledge of Microsoft Outlook and Microsoft Office applications. Ability to learn and effectively utilize surgical scheduling and facility systems, including Surgimate, iQueue, and other required platforms. Ability to accurately scan, file, retrieve, and organize electronic medical documentation.

Physical Requirements:

Sitting and viewing computer screen for extended periods Keyboarding for extended periods Standing or walking, up to 75% of the time Lifting, reaching, and bending, often Close visual acuity required to perform duties such as viewing computer monitor and determining accuracy and thoroughness of work.

Full-time immediate employee benefits:

Paid Time Off (PTO) 13 days per year, as accrued. 7 Paid Holidays per year. Scrub Allowance Ability to participate in company 401k plan offered through Fidelity. On the first of the month following 30 days of employment benefits: Medical insurance - employer pays 95% of premium of base HMO plan for employee (dependent coverage available for purchase). Group dental, vision, life, and accident plans available for purchase. Flexible Spending Account participation available. Allows pre-tax deferrals of amounts for medical, dental or vision premiums Allows pre-tax deferrals for dependent care expenses, subject to limitations After 90 days of employment - Paid Sick Leave of 5 days per year (California Residents Only). After one year of service - 401K Plan Safe Harbor contribution (3% of annual earnings) received after plan year ends.