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About the Role

The Practice Coordinator is primarily responsible for representing the administrative team as the public face of the Practice and works closely with the administrative, clinical and management teams to support practice operations and customer service recovery and intervention efforts. Provides support to all functions of the administrative teams including but not limited to: CRM messages, telephone encounters, referrals, APeX in-baskets, scanning, filing, authorizations, and billing. The PC 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 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 to maximize unit efficiency. The PC is required to work at any UCSF campus as needed and scheduled.

Responsibilities

• Reviews and works referral workqueues daily, documenting activities within the referral record.
• Acts as the primary contact for referring physicians and new patients.
• Maintains electronic logs for external referrals and creates referral records for accurate tracking and documentation.
• Assigns new patients to providers based on scheduling issues.
• Schedules and registers patients by telephone or in person, meeting accuracy and performance standards.
• Completes appropriate practice intake paperwork and follows established practice guidelines to ensure new patients are seen within prescribed time lines.
• Communicates any problems with the schedule with the supervisor.
• Collects and verifies insurance and referral/authorization information for the first appointment.
• Ensures referral records and Hospital Accounts Records (HARS) are created and assigned to the appointment.
• Schedules and coordinates any pre-appointment tests or appointments.
• Explains first appointment procedures in layman’s terminology to patients.
• Prepares and mails New Patient Packet or sends through MyChart.
• Provides other information requested by the patient.
• Gives directions and instructions to patients before the first appointment.
• Manages patient expectations by providing practice-specific guidelines related to service/visit.
• Seeks clinical input when appropriate.
• Creates a professional and positive first impression for patients and referring physicians.
• Demonstrates good judgment and common sense.
• Secures outside medical records, CDs of scans and pathology slides, reviewing them for completeness.
• Determines which physician can best evaluate the patient.
• Prioritizes new patient scheduling based on diagnosis and current treatment status.
• Schedules complex patients according to practice priorities.
• Informs patients about possible treatment scheduling options, clinical trials and screening.
• Coordinates with appropriate research personnel and the appropriate physician.
• Consults with the appropriate department to coordinate care, optimize schedules, and expedite services for patients who would benefit from a consultation with other clinical disciplines.
• Meets with patients after the new patient visit to explain how care is coordinated with possible clinical trials, testing, surgical procedures and care within other departments.
• Coordinates scheduling of all outpatient and inpatient surgeries for the surgical practice.
• Ensures that all surgical procedures are scheduled within a clinically appropriate time frame.
• Interfaces with patients, physicians and hospital staff to ensure adequate communication regarding all aspects of surgical services.
• Coordinates surgical activities with physician’s other responsibilities.
• Processes complex hospital admission forms, schedules pre-surgical tests and appointments, and secures all necessary resources and equipment for surgery.
• Manages complex scheduling coordination related to securing OR time outside of designated block time.
• Works to maximize OR and surgical robot utilization as well as complex joint cases.
• Coordinates pre-operative anesthesia appointments with other testing, authorization coding and scheduling the surgery in Op-Time.
• Manages complex admission, discharge and planning coordination involving hospital reservations and authorizations related to study patients on protocol, transfers from outside hospitals and post transfer urgent authorizations and surgical planning.
• Works with patients and staff to confirm availability and accuracy of medical information within APeX and to ensure compliance with all hospital policies and procedures.
• Secures authorization for surgical procedures and coordinates with Hospital Admissions Department as needed.
• Communicates with the surgeon post-surgery to confirm if any additional surgical procedure was performed and to follow up with the insurance company immediately to amend the authorization.
• Acts as primary liaison to procedure billing team to coordinate updated authorizations and or TARs for mid procedure changes or additions.
• Ensures compliance with Medical Center bylaws and Regulations ensuring the diagnosis is confirmed before treatment is offered through formal review of any and all outside studies and pathology.
• Ensures appropriate and timely communication and documentation with the patient and the physician.
• Secures surgical consent for cosmetic services, including identification of cases, cosmetic price guidelines, quote prices and coordinate payment.
• Analyzes the pricing structure to ensure that the prices remain competitive and are updated as needed.
• Arranges post-surgical appointments and testing, which may include Home Care, Physical Therapy, durable medical equipment, and Workers Compensation paperwork.
• Performs cash collection and depositing functions as assigned, complying with all established policies and procedures.
• Communicates Medical Center administrative and financial policies clearly to patients, answering patient account questions.
• Obtains and documents insurance authorizations for established patient visits, referrals and procedures or ancillary services.
• Communicates clinical information from medical records authorization requests to insurance companies.
• Demonstrates competency working with CPT codes and ICD-9 and ICD-10 for the purpose of scheduling and securing authorization.
• Monitors provider(s) open charts and encounters and works with providers to complete encounter documentation in a timely manner to support revenue cycle workflow.
• Assists provider with instructions on how to close encounters opened in error.
• Works RFI workqueues to secure information for accurate billing submissions or to respond to denials.
• Secures authorization for procedures, specialty visits and ancillary testing and coordinates with Hospital Admissions Department as needed.
• Provides assistance with complex DME authorizations that often require precise documentation in specific formats to receive approval.
• Provides assistance with medication authorization for new medications and refills.
• Secures complex insurance authorizations for services, medications, or testing and tracks authorizations for renewal.
• Demonstrates competency working with HCPC codes and is able to look up and locate the appropriate codes for the purpose of requesting authorization.
• Identifies and interprets a patient’s insurance benefit package, including pharmacy and mental health carve outs.
• Utilizes insurance benefit information to direct authorization requests and coordinate services for patients.
• Reviews & analyzes monthly denial reports for both professional and hospital billing.
• Initiates retro authorizations from denial report.
• Identifies trends in denials and works with the practice team and supervisors to develop and implement improved workflows to minimize denials.
• Compiles & analyzes data for reports to track basic revenue cycle measurements such as charges, payments, visit volume, etc.
• Creates reports in Microsoft Excel.
• Oversees and coaches staff on complex authorization requests.
• Addresses patient complaints regarding billing and complaints related to billing that come out of Patient Relations.
• Tracks patterns of billing complaints and identifies patterns which can be addressed with coaching and education of staff and providers.
• Understands the concept of managed care and is knowledgeable about the resources available to the staff.
• Assists patients to understand the concept of managed care.
• Reviews all upcoming visits to determine patient eligibility.
• Assists with transitioning patients who are no longer eligible to new primary care practices through collaboration with the practice Social Worker and clinical teams.
• Serves as department resource for insurance questions and insurance updates.
• Includes important updates in the practice newsletter.
• Drafts newsletter announcements.
• As practice SuperUser, produces reports and reviews with staff cash collection barriers to improve cash collection rates for the practice.
• Greets and welcomes patients making eye contact and utilizing AIDET standards.
• Determines a patient’s co-pay obligation and collects it at the time of the visit.
• May also collect payments on patient accounts.
• Gives priority to the timely registration of patients on check-in.
• Maintains practice flow, paying careful attention to performance improvement initiatives to reduce delays.
• Communicates with patients in a confidential professional manner using tact and diplomacy.
• Monitors and maintains the reception area, making sure it is tidy and there is adequate availability of reading and educational materials.
• Ensures that the temperature of the reception area is comfortable and that there is adequate and appropriate seating for all patients.
• Observes the waiting area and performs customer service intervention when patients have been waiting a long time or are not receiving adequate service.
• Assists patients with use of Kiosk and actively works to promote Kiosk utilization.
• Responsible for front end office responsibilities to include registration and front desk duties, referral processing, authorization coordination and review, cash deposits, DME oversight and scheduling functions.
• Acts as a Care Support Assistant for the Delivery System Reform Incentive Payment (DSRIP) funded clinical team.
• Develops and analyzes front desk productivity reports in partnership with the management team to improve co-pay collection rates and accurate payer plan capture.
• Identifies opportunities for productivity improvement and assists management team with staff coaching and workflow enhancement.
• Creates Cadence schedule templates for providers.
• Ensures templates are user friendly and help promote consistent clinic access.
• Generates reschedule reports in Cadence and works with other members of the administrative team to ensure patients are rescheduled in a timely manner.
• Schedules established patient appointments using Apex and its related components.
• Understands the distinction of each medical practice and how care is delivered in each setting.
• Coordinates appointments with multiple providers as required.
• Discusses practice policies and procedures with patients and referring physicians.
• Answers questions about provider schedules and acts as a resource to other medical center practices and ancillary service administrative staff.
• Screens all telephone calls, screening for emergencies and routing all messages, requests for same day appointments, refill requests, etc. to the appropriate box.
• Utilizes legacy systems and Apex to retrieve pertinent patient data.
• Follows practice procedure for follow-up of missed appointments.
• Covers Apex in-baskets and phone messages when other members of the team are absent.
• Adjusts priorities as required for smooth operation of the practice and notifies the clinical staff.
• Provides administrative support to providers in coordination of patient care (i.e. sending patient letters, educational materials, results of lab tests, etc.).
• Schedules procedures and tests providing appropriate instructions to patients.
• Collaborates with clinical staff in problem-solving patient needs and requests for same day appointments and other appointments requiring care coordination.
• Works together with the clinical staff in the processing and follow-through of urgent patient needs.
• Demonstrates courtesy and overt helpfulness in all interactions.
• Collaborates with Practice Supervisor and Administrative Director in the resolution of patient complaints.
• Assists in maintaining current filing and scanning.
• Understands the distinction of multiple clinical symptoms and their associated escalation level with a common sense approach for when it is appropriate to escalate or take action to speed along a process within the practice or to obtain immediate clinical intervention.
• Utilizes advanced customer service skills in working with and providing exceptional customer service to patients who are medication dependent and may exhibit challenging behaviors.
• Understands how to deescalate a difficult encounter and when to seek additional support from leadership.
• Protects the safety of the work environment.
• Acts as liaison with Concierge Services.
• Expedites requested services.
• Coordinates complex patient care coordination activities.
• Arranges appointments and testing, which may include Tumor block genetic testing, Home Care, Physical Therapy, starting paperwork for durable medical equipment or disability paperwork and following up on all other paperwork, i.e. Workers Compensation as necessary.
• Keeps track of patients who have parallel pathways for their medical care and works with clinical providers to take steps at critical points along the continuum.
• Creates and maintains APeX patient lists or Excel Spreadsheets for tracking purposes.
• Books Radiology appointments directly into Radiology scheduling software while ensuring accuracy of exam types, location specifications and insurance restrictions.
• Identifies referral problems; reports out to management team with suggested solutions.
• Develops and reviews reports related to referral management, tracking and updating management team with ongoing outgoing and incoming referral issues as they arise.
• Oversight with maintaining Open Access schedules in order to meet the Patient-Centered Medical Home (PCMH) standards.
• Performs APEX specific Patient Care Coordinator (PCC) functions as appropriate to completion of APEX PCC training and job duties.
• Enters new incoming referrals entering authorization information as appropriate.
• Updates and closes CRM messages and converts CRM messages into telephone encounters if practice is serviced by the Ambulatory Services Call Center.
• Opens, documents within, routes and closes telephone encounters.
• Accurately utilizes documentation steps when leaving a telephone encounter open pending further communications with the caller.
• Utilizes smart text logic to document patient phone screening as associated with complex appointment scheduling.
• Works applicable APeX workqueues to address patient care and service matters.
• Creates and sends administrative communications via MyChart.
• Creates SmartPhrase templates associated with administrative functions.
• Creates and routes patient letters associated with administrative matters.
• Performs enter/edit outside test results following established workflow and steps.
• Encourages use of the check in kiosk and troubleshoots technical or customer service issues.
• Modifies order class of labs from lab collection vs. clinic collection or UCSF Collect vs. External Collect.
• Performs advanced appointment scheduling using complex scheduling protocols from a variety of ancillary and subspecialty services some of which will require authorization.
• Supports Patient-Centered Medical Home, Standard 1 guidelines that require patients have daily available appointment access to the practice.
• If no appointments are available, coordinates them at another site or within Adult or Pediatric Urgent Care.
• Responds to telephone calls from patients seeking medical care at UCSF Medical Center.
• Utilizes the EPIC Appointment Scheduling System (Cadence) to schedule patient appointments in accordance with practice policy.
• Documents call information in the EPIC CRM in a concise, accurate manner.
• Converts CRM messages to telephone encounters according to practice guidelines and workflows.
• Responds to patient’s online Web appointment requests for patients utilizing the online appointment system.
• Utilizes Phone Bank protocols to determine when to involve a clinician on a call due to urgent or emergent symptomatology.
• Pulls and prepares charts prior to patient appointment following established practice criteria.
• Files all patient related information, tracks incoming slides, films and reports as required by practice.
• Returns materials to referring physicians in a timely manner utilizing tracking systems.
• Scans and imports patient records and documents in APeX system following established guidelines and policies.
• Upholds UCSF Medical Center policy regarding the maintenance and confidentiality of medical records and other patient information.
• Maintains and adheres to patient confidentiality and HIPAA guidelines including the distribution of NOPPs (Notice of Privacy Practices).
• Participates in team building by actively contributing during meetings and with staff and providers in discussion of all practice activities.
• Attends training classes provided by Medical Center, Billing Agent, and others as necessary.
• Brings information back to practice and uses on the job.
• Works with supervisor and co-workers to ensure that the practice responds comprehensively to patient care needs through improved procedures and administrative systems.
• Is an active participant in performance improvement projects and customer service initiatives.
• Complies with all Medical Center and Ambulatory Services procedures for infection control, safety, administrative and clinical practice.
• Complies with activities mandated by Joint Commission, Title 22.
• Fills in for other co-workers to help address work load problems and cover vacation or sick leave openings.
• Maintains provider calendars.
• When working in a primary care practice, assists with the delivery and maintenance of a high standard of patient care using the Patient Centered Medical Home model.
• Acts as the coordinator for all of patient’s needs such as forms (ie. work release, disability, immunization records, etc.) when working within the primary care environment.
• Is principally responsible for the continuity of care for patients which includes a significant amount of support for patients at the time of the visit and between visits.
• Provides 1:1 and team training for new hires and new initiatives and procedures.
• Facilitates Float coverage as needed for practice.
• Serves on and contributes documentation to the Patient Centered Medical Home application workgroup.
• Reports any malfunctioning of equipment.
• Complies with recommendations made by ergonomic specialists to avoid workplace injury.
• Complies with infection control policies related (e.g. does not eat at the front desk or in patient care areas).
• Serves as practice deputy for life / safety activities helps lead drills.
• Deals directly with patients either by telephone, electronically or face to face while consistently following EVERYDAY PRIDE principles in verbal and written communications.
• Responds promptly and courteously to internal and external inquiries.
• Stays logged into appropriate APeX Pools and In Baskets.
• Handles front line patient complaints with the support of the Practice Supervisor / Administrative Director.
• Supports all performance improvement initiatives as outlined by the Medical Center leadership through active participation and initiation.
• Obtains and evaluates all relevant information to handle inquiries and complaints.
• Acts and advocate for patients to help facilitate provider punctuality in seeing patients according to schedule.
• Communicates provider delays with front office team and makes regular announcements to waiting room as needed when delays are over 30 minutes.
• Offers suggestions for change or improvement in clinic/practice operations.
• Leads by example in the areas professional appearance, demeanor and body language, making eye contact with patients and internal customers, exhibits a friendly demeanor to put patients at ease.
• Seeks opportunities to improve patient convenience.
• Utilizes service recovery amenities as appropriate.
• Contributes to the development of a patient-focused environment.
• Addresses and resolves escalated issues of day to day operations (e.g. customer service, provider complaints, cross departmental communication or coordination problems, etc.).
• Serves as a liaison to management to advise on, take lead action on, and provide direction on process improvements initiatives.
• Acts as a primary resource for one or more designated functions in the department (e.g., APeX SuperUser).
• Provides feedback related to staff performance.
• Supports staff through orientation, training and oversight.
• Attends monthly organization meetings/trainings to enhance SuperUser role within the practice.
• Demonstrates innovation and flexibility regarding the modification of tasks or workflows within assigned duties and job functions.
• Perform other duties as assigned.
• Other clerical duties as assigned.

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 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, prioritizes, and develops solutions and makes recommendations.
• Ability to work with minimal supervision.
• Ability to use good judgment and work independently, at times under the pressure of deadlines.
• Ability to access situations prioritizes workload, develop solutions and make recommendations.
• 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.
• 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.

Skills

• CRM messages
• Telephone encounters
• Referrals
• APeX in-baskets
• Scanning
• Filing
• Authorizations
• Billing
• Computer skills
• Basic keyboarding skills
• Outlook
• Word
• Excel
• Navigating multiple patient records systems
• Basic math skills
• Organizational skills
• Problem-solving skills
• Writing skills
• Administrative/office coordination skills
• Medical practice terminology
• EPIC Appointment Scheduling System (Cadence)
• EPIC CRM
• MyChart
• SmartPhrase templates
• Microsoft Excel
• AIDET standards
• Kiosk utilization
• DSRIP
• CPT codes
• ICD-9
• ICD-10
• HCPC codes
• J codes
• Tumor block genetic testing
• Home Care
• Physical Therapy
• Durable medical equipment
• Workers Compensation
• Radiology scheduling software
• Open Access schedules
• Patient-Centered Medical Home (PCMH)
• APEX
• PCC functions
• CRM messages
• Telephone encounters
• APeX workqueues
• MyChart
• SmartPhrase templates
• Patient letters
• Outside test results
• Check in kiosk
• Order class modification
• Advanced appointment scheduling
• EPIC
• Cadence
• EVERYDAY PRIDE principles

Location

• UCSF campus

Work Type

• Full-time

Experience Level

• 4 years related experience
• 6 months related experience

Education Level

• High School graduate or equivalent
• College degree

Benefits

• Total compensation information available at: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html

About the Company

• 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 University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.
• It is the only campus in the 10-campus UC system dedicated exclusively to the health sciences.
• We bring together the world’s leading experts in nearly every area of health.
• We are home to five Nobel laureates who have advanced the understanding of cancer, neurodegenerative diseases, aging and stem cells.
• 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.
• Join us to find a rewarding career contributing to improving healthcare worldwide.

Equal Opportunity

• The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law.