Job Summary:

The Surgery Scheduling & Revenue Capture Coordinator ensures efficient and accurate surgical scheduling while supporting complete, compliant billing capture. This role partners with clinical teams, physicians, and revenue cycle departments to optimize operating room utilization, prevent denials, and support timely reimbursement. The Coordinator is responsible for scheduling surgical procedures, facilitating insurance verification and authorization processes, promoting revenue integrity through accurate charge capture, and maintaining effective communication with patients, providers, and interdisciplinary teams.

Supervisory Responsibilities:

•  None

Duties/Responsibilities:

• Coordinate scheduling of surgical procedures based on physician availability, block time utilization, equipment availability, and clinical urgency.
• Verify the accuracy and completeness of surgical scheduling information, including procedure details, laterality, surgeon preferences, and special equipment or implant needs.
• Communicate surgical schedules and changes effectively with surgeons, anesthesia providers, nursing staff, and ancillary departments.
• Manage cancellations, rescheduled procedures, and add-on cases to maximize operating room efficiency.
• Verify patient eligibility, insurance benefits, and coverage prior to scheduling procedures.
• Obtain and document prior authorizations for procedures, implants, and other payer-required services.
• Ensure supporting documentation meets payer medical necessity requirements.
• Collaborate with physician offices and insurance representatives to resolve authorization issues.
• Prepare patient estimates utilizing the Quadax Estimator.
• Ensure accurate procedure codes, modifiers, and charge triggers are identified during the scheduling process.
• Reconcile scheduled procedures against completed procedures to ensure accurate and complete charge capture.
• Identify and resolve missing or incorrect charges prior to claim submission.
• Collaborate with coding, billing, and revenue cycle departments to reduce claim denials and reimbursement delays.
• Support compliance with organizational policies, payer requirements, and regulatory standards related to billing and revenue integrity.
• Maintain accurate records within electronic medical record and scheduling systems.
• Ensure all required documentation is complete and available prior to surgery.
• Adhere to HIPAA, Texas HB 300, and organizational confidentiality standards related to patient and financial information.
• Participate in audits, quality improvement initiatives, and performance improvement activities related to surgical scheduling and revenue capture.
• Serve as a primary point of contact for physician offices regarding surgical scheduling coordination.
• Coordinate with physician offices to ensure accurate and complete scheduling information is obtained.
• Perform other related duties to benefit the mission of the organization.

Required Skills/Abilities:

• Strong organizational and time management skills.
• Must use and operate: Computer, Telephone, Facsimile Machine, Copier, Scanner, Printer, Calculator, and other Standard Office Equipment.
• Intermediate computer skills, including but not limited to: Microsoft Office, electronic medical and billing documentation, and email.
• Strong analytical and problem-solving skills with an excellent attention to detail with a high degree of accuracy.
• Excellent command/highly proficient in spoken and written English; bilingual in Spanish, preferred.
• Proper grammar and spelling required.

Job-related Skills and Abilities:

• Knowledge of medical terminology and surgical procedures.
• Working knowledge of insurance verification and authorization processes.
• Basic understanding of CPT, ICD, and HCPCS coding principles.
• Understanding of healthcare revenue cycle processes and charge capture principles.
• Ability to analyze discrepancies and identify opportunities to improve revenue integrity.
• Ability to coordinate effectively with physicians, clinical staff, and revenue cycle personnel.
• Ability to quickly learn and understand payer requirements and documentation standards related to surgical services.

Education and Experience:

• High school diploma or equivalent required.
• Associate's degree in healthcare administration, business, or related field preferred.
• Two (2) to five (5) years of experience in surgical scheduling, healthcare administration, revenue cycle operations, or a related healthcare setting required.
• Experience with insurance verification and prior authorization processes preferred.
• Experience utilizing electronic medical record systems and scheduling software required.
• Certification in healthcare access management, medical office administration, or revenue cycle operations preferred.

Physical and Mental Requirements:

• Prolonged periods of sitting at a desk and working on a computer.
• Frequent use of hands and fingers for typing, writing, and operating office equipment.
• Ability to communicate effectively in person and via telephone.
• Must be able to navigate various departments within the organization.
• Must be able to lift and carry up to 30 pounds occasionally.
• Adequate visual acuity to review electronic and paper records and perform data entry tasks accurately.
• Adequate hearing ability to communicate effectively with patients, providers, and staff.
• Ability to maintain concentration and accuracy in a fast-paced environment with frequent interruptions.
• Ability to exercise critical thinking, problem-solving, and sound judgment.
• Stress Level: Moderate

OSHA Classification:

Category II: Tasks that involve no routine exposure to blood, body fluids, or tissues, but employment may require performing unplanned Category I tasks.

The normal work routine involves no exposure to blood, body fluids, or tissues; however, exposure may occur as a condition of employment. Appropriate protective measures, such as gloves, masks, goggles, and gowns, are readily available to employees engaged in Category II tasks.