PRACTICE CRD 3

UCSF•San Francisco, CA

2d•$36 - $52

About The Position

The Practice Coordinator 3 (PC 3) serves as the public face of the administrative team, supporting practice operations and customer service recovery. This role works closely with administrative, clinical, and management teams to handle various administrative functions, including CRM messages, insurance eligibility verification, authorization submissions, billing cycle maintenance, telephone encounters, new patient and follow-up referrals, APeX in-baskets messaging, scanning, and patient registration. The PC 3 is responsible for maintaining routine clerical operations and communications, acting as a flexible team player who can problem-solve and prioritize complex transactions. This position makes a difference for patients in an outpatient care unit by providing excellent customer service and ensuring accurate information flow between medical, hospital staff, and departments to maximize unit efficiency.

Requirements

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.
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 periods 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.
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: Referrals (Incoming referral entry) and handling all referral WQs, Pend orders, Pend smart sets, Schedule surgeries, Work applicable work queues, Enter/edit outside test results, Messaging (CRM) if applicable, 2nd calls in CRM if applicable, Telephone encounters, My open encounter, Staff message, New message, Route Patient advice request to providers (My Chart), Patient Schedule (My Chart), Letters, Pools, Patient look up, Check in process, Check out process, Comment field, Quick note, Scanning.

Nice To Haves

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.

Responsibilities

Review and work referral workqueues, documenting activities within the referral record.
Act as the primary contact for referring physicians and new patients.
Maintain electronic logs for external referrals and create referral records for accurate tracking.
Assign new patients to providers, considering scheduling issues.
Schedule and register patients by telephone or in person, meeting accuracy and performance standards.
Complete appropriate practice intake paperwork and follow established guidelines to ensure new patients are seen within prescribed timelines.
Collect and verify insurance and referral/authorization information for the first appointment.
Schedule and coordinate any pre-appointment tests or appointments.
Explain first appointment procedures, required records, and provide other requested information to patients.
Give directions and instructions to patients before the first appointment and manage patient expectations.
Create a professional and positive first impression for patients and referring physicians.
Secure outside medical records, CDs of scans, and pathology slides, reviewing them for completeness.
Prioritize new patient scheduling based on diagnosis and current treatment status.
Inform patients about possible treatment scheduling options, clinical trials, and coordinate screenings with research personnel and physicians.
Consult with appropriate departments to coordinate care, optimize schedules, and expedite services for patients needing multidisciplinary consultations.
Meet with patients after new patient visits to explain care coordination with clinical trials, testing, surgical procedures, and other departments/providers.
Coordinate scheduling of all outpatient and inpatient surgeries, ensuring procedures are scheduled within a clinically appropriate timeframe.
Interface with patients, physicians, and hospital staff to ensure adequate communication regarding surgical services.
Coordinate surgical activities with physician's other responsibilities.
Process complex hospital admission forms, schedule pre-surgical tests and appointments, and secure necessary resources and equipment for surgery.
Manage complex scheduling coordination for securing OR time outside of designated block time.
Maximize OR and surgical robot utilization, as well as complex joint cases.
Coordinate pre-operative anesthesia appointments with other testing, authorization coding, and scheduling the surgery in Op-Time.
Manage complex admission, discharge, and planning coordination involving hospital reservations and authorizations for study patients on protocol, transfers from outside hospitals, and post-transfer urgent authorizations and surgical planning.
Confirm availability and accuracy of medical information within APeX and ensure compliance with hospital policies and procedures.
Secure authorization for surgical procedures and coordinate with the Hospital Admissions Department.
Communicate with the surgeon post-surgery to confirm any additional procedures and amend authorizations.
Act as a primary liaison to the procedure billing team to coordinate updated authorizations and/or TARs for mid-procedure changes or additions.
Ensure compliance with Medical Center bylaws and Regulations by reviewing outside studies and pathology.
Secure surgical consent for cosmetic services, including pricing and payment coordination.
Analyze pricing structures to ensure competitiveness and update as needed for elective cosmetic services.
Arrange post-surgical appointments and testing, including Home Care, Physical Therapy, and durable medical equipment paperwork.
Perform cash collection and depositing functions as assigned, complying with policies and procedures.
Communicate Medical Center administrative and financial policies clearly to patients, answering account questions and referring to appropriate support departments.
Obtain and document insurance authorizations for established patient visits, referrals, and procedures or ancillary services.
Communicate clinical information from medical records to authorization requests to insurance companies.
Demonstrate competency working with CPT codes and ICD-9 and ICD-10 for scheduling and authorization.
Monitor provider(s) open charts and encounters and work with providers to complete encounter documentation.
Work RFI workqueues to secure information for accurate billing submissions or to respond to denials.
Secure authorization for procedures, specialty visits, and ancillary testing.
Provide assistance with complex DME authorizations that require precise documentation.
Provide assistance with medication authorization for new medications and refills.
Secure complex insurance authorizations for services, medications, or testing and track renewals.
Demonstrate competency working with HCPC codes and locating appropriate codes for authorization requests.
Identify and interpret a patient’s insurance benefit package, including pharmacy and mental health carve outs.
Review and analyze monthly denial reports for professional and hospital billing, initiating retro authorizations.
Identify trends in denials and work with the practice team to develop and implement improved workflows.
Compile and analyze data for reports to track basic revenue cycle measurements and create reports in Microsoft Excel.
Oversee and coach staff on complex authorization requests.
Address patient complaints regarding billing and those from Patient Relations.
Track patterns of billing complaints and identify trends for coaching and education.
Understand the concept of managed care and available resources, assisting patients to understand it.
Review upcoming visits to determine patient eligibility and assist with transitioning patients who are no longer eligible.
Serve as a department resource for insurance questions and updates, including reviewing updates with the administrative team and including them in the practice newsletter.
As practice SuperUser, produce reports and review cash collection barriers with staff to improve rates.
Greet and welcome patients, making eye contact and utilizing AIDET standards.
Determine a patient’s co-pay obligation and collect it at the time of the visit; may also collect payments on patient accounts.
Prioritize timely registration of patients on check-in and maintain practice flow.
Communicate with patients in a confidential, professional manner using tact and diplomacy.
Monitor and maintain the reception area, ensuring it is tidy and has adequate materials, comfortable temperature, and appropriate seating.
Observe the waiting area and perform customer service intervention for patients experiencing long waits or inadequate service.
Assist patients with Kiosk use and promote Kiosk utilization.
Perform front-end office responsibilities including registration, front desk duties, referral processing, authorization coordination and review, cash deposits, DME oversight, and scheduling.
Act as a Care Support Assistant for the DSRIP funded clinical team.
Develop and analyze front desk productivity reports to improve co-pay collection rates and payer plan capture.
Identify opportunities for productivity improvement and assist management with staff coaching and workflow enhancement.
Create Cadence schedule templates for providers.
Ensure template construction is user-friendly and promotes consistent clinic access.
Generate reschedule reports in Cadence and work with the administrative team to ensure timely rescheduling.
Schedule established patient appointments using Apex and its related components.
Understand the distinction of each medical practice and how care is delivered in each setting.
Coordinate appointments with multiple providers as required.
Discuss practice policies and procedures with patients and referring physicians.
Answer questions about provider schedules and act as a resource to other medical center practices and ancillary service administrative staff.
Provide prompt and convenient appointment access to patients.
Adhere to provider productivity standards as established in APEX templates and schedule appointments with the appropriate appointment type.
Triage all telephone calls, screening for emergencies and routing messages, requests, and refill requests to the appropriate box.
Utilize legacy systems and Apex to retrieve pertinent patient data.
Follow practice procedure for follow-up of missed appointments.
Cover Apex in-baskets and phone messages when other team members are absent.
Adjust priorities as required for smooth practice operation and notify clinical staff.
Provide administrative support to providers in coordination of patient care (e.g., sending patient letters, educational materials, results of lab tests).
Schedule procedures and tests, providing appropriate instructions to patients.
Collaborate with clinical staff in problem-solving patient needs and requests for same-day appointments and other appointments requiring care coordination.
Process and follow through on urgent patient needs with clinical staff.
Demonstrate courtesy and helpfulness in all interactions.
Collaborate with Practice Supervisor and Administrative Director in the resolution of patient complaints.
Assist in maintaining current filing and scanning.
Understand multiple clinical symptoms and their associated escalation levels for appropriate action or escalation.
Utilize advanced customer service skills with patients who may exhibit challenging behaviors, including de-escalation and seeking support.
Act as liaison with Concierge Services and expedite requested services.
Coordinate complex patient care coordination activities, including appointments and testing (e.g., tumor block genetic testing, Home Care, Physical Therapy, DME, disability paperwork, Workers Compensation).
Keep track of patients with parallel pathways for medical care and work with clinical providers to take steps at critical points.
Create and maintain APeX patient lists or Excel Spreadsheets for tracking purposes.
Book Radiology appointments directly into Radiology scheduling software, ensuring accuracy of exam types, location specifications, and insurance restrictions.
Identify referral problems and report them to the management team with suggested solutions.
Develop and review reports related to referral management, tracking and updating the management team with referral issues.
Maintain Open Access schedules to meet Patient-Centered Medical Home (PCMH) standards.
Perform APEX specific Patient Care Coordinator (PCC) functions: enter new incoming referrals, update and close CRM messages, open/document/route/close telephone encounters, work applicable APeX workqueues, create and send administrative communications via MyChart, create SmartPhrase templates, create and route patient letters, enter/edit outside test results, encourage check-in kiosk use and troubleshoot issues.
Pend orders (med refills, referrals, procedures) associated with a diagnosis and route to provider for review.
Pend Smart Sets with proper orders and diagnosis and route to provider for review.
Modify order class of labs.
Perform advanced appointment scheduling using complex scheduling protocols.
Support Patient-Centered Medical Home guidelines for daily available appointment access.
Respond to telephone calls from patients seeking medical care.
Utilize the EPIC Appointment Scheduling System (Cadence) to schedule patient appointments.
Document call information in the EPIC CRM concisely and accurately.
Convert CRM messages to telephone encounters according to practice guidelines.
Respond to patient’s online Web appointment requests.
Utilize Phone Bank protocols to determine when to involve a clinician on a call due to urgent or emergent symptomatology.
Pull and prepare charts prior to patient appointments.
File all patient-related information, track incoming slides, films, and reports, and return materials to referring physicians.
Scan and import patient records and documents in APeX system.
Uphold UCSF Medical Center policy regarding the maintenance and confidentiality of medical records and patient information.
Participate in team building by actively contributing during meetings and discussions.
Attend training classes and bring information back to practice for use on the job.
Work with supervisor and co-workers to ensure the practice responds comprehensively to patient care needs.
Comply with all Medical Center and Ambulatory Services procedures for infection control, safety, administrative, and clinical practice.
Fill in for other co-workers to address workload problems and cover absences.
Facilitate Float coverage as needed for practice.
Serve on and contribute documentation to the Patient Centered Medical Home application workgroup.
Deal directly with patients by telephone, electronically, or face-to-face while following EVERYDAY PRIDE principles.
Respond promptly and courteously to internal and external inquiries.
Stay logged into appropriate APeX Pools and In Baskets.
Handle front-line patient complaints with support from the Practice Supervisor / Administrative Director.
Support all performance improvement initiatives.
Obtain and evaluate all relevant information to handle inquiries and complaints.
Build rapport with patients quickly and work effectively with or without supervision.
Remain calm and friendly in all interactions with patients.
Notify providers of patient delays and service issues.
Act as an advocate for patients to help facilitate provider punctuality.
Communicate provider delays with the front office team and make announcements to the waiting room.
Offer suggestions for change or improvement in clinic/practice operations.
Lead by example in professional appearance, demeanor, and body language.
Seek opportunities to improve patient convenience and utilize service recovery amenities.
Contribute to the development of a patient-focused environment.
Address and resolve escalated issues of day-to-day operations.
Serve as a liaison to management to advise on and lead process improvement initiatives.
Act as a primary resource for one or more designated functions in the department (e.g., APeX SuperUser).
Provide feedback related to staff performance.
Support staff through orientation, training, and oversight.
Attend monthly organization meetings/trainings to enhance SuperUser role.
Synthesize knowledge of practice operations to problem-solve, prioritize, and facilitate complex transactions.