Practice Coordinator Auth Rep 2

Practice Coordinator Auth Rep 2

FPO Prior Authorization Unit

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Full Time

75447BR

Job Summary

As a patient-focused organization, UCSF Medical Center exists to enhance the health and well-being of people through patient care, research and education.

Success in this mission requires a culture of collaboration, excellence, leadership, and respect. UCSF Medical Center seeks faculty and staff that are committed to the values of professionalism, respect, integrity, diversity, and excellence that are integral to our mission.

The PC Authorization Coordinator is primarily responsible for securing financial clearance for the patient, provider and health system.

The coordinator works closely with the administrative, clinical and management teams to support practice operations and customer service recovery and intervention efforts.

Provides support for financial clearance functions including authorizations, PAFRs, LOAs billing and RFIs. Under the direction of the Revenue Manager and / or supervisor, the biller / auth rep will work independently to resolve billing related issues in APeX (Epic) to help maximize payor reimbursement and RVU charge capture.

He / she must have basic understanding of healthcare terminology, processes and workflow and healthcare billing / authorizations in order to make good decisions and resolve account issues.

This position will also be responsible for performing detailed review of medical record documentation to answer billing / authorization level questions and will be responsible for working assigned authorization and billing work queues (WQs) on a daily basis to assist in keeping the denials at a minimum.

He / she must have the ability to prioritize multiple tasks and work well with all levels of staffing including faculty, management, and coworkers both within and outside of the unit.

The PC Authorization Coordinator is responsible for the maintenance of all routine clerical operations and communications.

Adheres to the UCSF House and Telephone Standards and is sensitive to the needs of patients, staff and providers at all times.

The PC is a team player who works closely with others and who is flexible in dealing with the changing priorities. Requires a self-reliant individual who synthesizes knowledge of practice operations as well as billing operations, in order to problem-solve, prioritize and facilitate complex transactions in the course of daily activities.

This position makes a difference for patients in an outpatient care unit by providing excellent customer service, facilitating and ensuring the accuracy of the information flow between medical, hospital staff and departments and insurance companies to maximize unit efficiency.

The PC is required to work at any UCSF campus as needed and scheduled.

The final salary and offer components are subject to additional approvals based on UC policy.

Required Qualifications

High School graduate or equivalent with four years related experience; or college degree and 6 months related experience;

or equivalent combination of education and experience.

• Successfully passes fingerprinting protocol and is approved to be a cash collector if applicable.
• Strong computer skills, including basic keyboarding skills, and experience with at least two Office-type software programs (i.

e., Outlook, Word and Excel). Proven ability to navigate through multiple patient records systems. Able to sit at a computer terminal with telephone headphones for extended period of time.

• Ability to analyze situations, prioritize, and develop solutions and make recommendations.
• Ability to work with minimal supervision.
• Ability to use good judgment and work independently at times under the pressure of deadlines.
• Excellent customer service and communication / interpersonal skills, both over the telephone and directly.
• Able to sit at a computer terminal with telephone headphones for extended periods of time.
• Basic math skills required.
• Proven ability to deal with a wide variety of individuals.
• Ability to deal sensitively and effectively with patients.
• Excellent organizational and problem-solving skills.
• Strong writing skills to include the ability to compose, edit, and proof a wide variety of documents.
• Demonstrated administrative / office coordination skills.
• Demonstrated knowledge of medical practice terminology.

Within six months of start date, based upon completion of training, the Supervisor, completes the proficiency checklist with the employee.

This includes the following areas if applicable :

• Complete basic to moderately complex authorizations independently.
• Work applicable work queues.
• Right Fax.
• Use of the Authorization / Certification Table.
• Ensure they have access to all Payer websites and can utilize all proficiently.
• Efficiently obtain authorizations within or exceeding productivity requirements.
• Review and verify benefits as needed, update in Apex.
• New message.
• Route authorization queries to practice (My Chart).
• Patient Schedule (My Chart).
• Letters.
• Pools.
• Patient look up.
• Comment field.
• Quick note.
• Scanning.

Preferred Qualifications

• Demonstrated experience in health care (may include medical, dental or veterinary) in the following areas : patient scheduling, insurance verification, medical record data abstraction, or patient financial services.
• Prior experience with appointment, ancillary service or surgical scheduling or a combination of all three.
• Bi-lingual or multi-lingual capability (Spanish, Cantonese, and Russian) strongly preferred.
• Prior experience with EPIC.

About UCSF

At UCSF Health, our mission of innovative patient care, advanced technology and pioneering research is redefining what's possible for the patients we serve - a promise we share with the professionals who make up our team.

Consistently ranked among the top 10 hospitals nationwide by U.S. News & World Report - UCSF Health is committed to providing the most rewarding work experience while delivering the best care available anywhere.

In an environment that allows for continuous learning and opportunities for professional growth, UCSF Health offers the ideal atmosphere in which to best use your skills and talents.

Pride Values

UCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity and excellence - also known as our PRIDE values.

In addition to our PRIDE values, UCSF is committed to equity - both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care.

Additional information about UCSF is available at diversity.ucsf.edu. Join us to find a rewarding career contributing to improving healthcare worldwide.

Equal Employment Opportunity

The University of California San Francisco is an Equal Opportunity / Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Organization

Health

Job Code and Payroll Title

004819 PRACTICE CRD 2

Job Category

Administrative Support

Bargaining Unit

Teamsters Local 2010 - Clerical and Allied Services Unit (CX)

Employee Class

Career

Percentage

100%

Location

Emeryville, CA

Shift

Days

Shift Length

8 Hours

Additional Shift Details

Monday - Friday

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