Job Purpose:

The Surgical Coordination Specialist supports surgeons through comprehensive surgical and procedural coordination, including precertification, scheduling, appeals management, and multi-department communication ensuring timely, accurate, and patient-centered care.

Primary Duties and Responsibilities:

• Coordinate and schedule surgeries and procedures as needed across ambulatory surgery center, clinic and hospital settings, ensuring accurate case posting, equipment needs, CPT/ICD-10 accuracy, and alignment with facility protocols.

• Perform precertification and prior authorizations for surgeries and procedures as needed via ECW, HST, and payer portals including Availity.

• Prepare and submit appeals for denied cases, coordinating peer-to-peer reviews and gathering medical necessity documentation.

• Maintain complete and accurate EMR documentation including authorization status, case details, and patient communication.

• Track financial clearance and collaborate with VOB teams to resolve issues.

• Communicate detailed pre-op and procedural instructions to patients. Assist with scheduling labs, clearances, and post op appointments.

• Maintain and monitor surgeon schedules, anticipating changes and communicating updates to

anesthesia, ambulatory surgery center schedulers, hospital schedulers, and clinic staff.

• Implement cross-functional best practices such as code-matching accuracy, payer policy monitoring, and proactive delays/denials avoidance.

• Monitor payer rule updates impacting procedures.

• Ensure timely submission and processing of authorizations within payer-required timeframes.

• Monitor and track appeal processes to achieve a high overturn rate for denied cases.

• Oversee the accuracy of surgery scheduling and procedure scheduling as needed, including correct coding, documentation, and verification of facility requirements.

• Monitor and minimize case cancellation rates through effective root-cause analysis and process improvement.

• Other duties as assigned.

Competencies:

• Service: We align our actions and decision making with the organization’s guiding platform keeping our patients at the center of all we do.

• Change Agent: We support and contribute to positive change in the organization.

• Communication and Interpersonal Relations: We communicate honestly and with compassion to build connections with our patients and each other.

• Effectiveness: We take ownership of work, doing the right thing for our customer and doing it well.

Organizational Culture:

All OrthoIllinois employees focus on service by putting the mission, vision, and value statements into practice and using the guiding principles of Compassion, Respect, Trust, Integrity, Innovation, Education Fiscal Responsibility, Practice Independence, Accountability, and Empowerment to direct their interactions and decision making. Employees promote and model the service standards to create lasting impressions, extraordinary moments, exceptional on-stage experiences, and meaningful and compassionate connections.

Education and Experience Requirements:

• High School Diploma or GED required; Associate’s or Bachelor’s preferred.

• Minimum 3+ years of surgery scheduling experience preferred.

• Prior authorization experience required, spine experience preferred.

• Proficient in ECW, HST, Availity, CPT and ICD-10 coding.

Environmental/Working Conditions:

Working environment is in an office/clinic setting with collaborative work across ASC and hospital partners.

Physical/Mental Demands:

• Sit for long periods of time

• Lifting, carrying and/or moving objects up to 20 pounds in a manner consistent with most office environments

• Finger dexterity, the ability to twist hands/wrists repetitively, and type on a keyboard

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.