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About the Role

The Practice Coordinator is responsible for representing the administrative team as the public face of the Practice, supporting practice operations and customer service. This role provides support to various administrative functions including CRM messages, telephone encounters, referrals, APeX in-baskets, scanning, filing, authorizations, and billing. The PC maintains routine clerical operations and communications, adhering to UCSF House and Telephone Standards, and is sensitive to the needs of patients, staff, and providers. This position makes a difference for patients by providing excellent customer service and facilitating accurate information flow between medical staff and departments to maximize unit efficiency.

Responsibilities

Reviews and works referral workqueues, 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 tracking.
Assigns new patients to providers, considering scheduling issues.
Schedules and registers patients by telephone or in person, meeting accuracy and performance standards.
Completes appropriate practice intake paperwork and follows guidelines to ensure new patients are seen within prescribed timelines.
Communicates schedule problems 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 Packets or sends through MyChart.
Provides other information requested by patients.
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, CD’s 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.
Informs patients about possible treatment scheduling options, clinical trials, and screening.
Coordinates with appropriate research personnel and physicians.
Consults with appropriate departments to coordinate care for patients who would benefit from other clinical disciplines.
Works to coordinate care, optimize schedules, and expedite services.
Meets with new patients after their visit to explain care coordination.
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 surgical services.
Interacts with clinical and academic staff to coordinate surgical activities with physician’s other responsibilities.
Processes complex hospital admission forms.
Schedules pre-surgical tests and appointments.
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 robots 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 for 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.
Ensures compliance with all hospital policies and procedures.
Secures authorization for surgical procedures and coordinates with Hospital Admissions Department.
Communicates with the surgeon post-surgery to confirm any additional surgical procedures performed.
Follows up with the insurance company immediately to amend the authorization.
Acts as primary liaison to the procedure billing team to coordinate updated authorizations and/or TARs for mid-procedure changes or additions.
Ensures compliance with Medical Center bylaws and Regulations.
Confirms diagnosis 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 pricing structure to ensure prices remain competitive and are updated as needed.
Arranges post-surgical appointments and testing, which may include Home Care, Physical Therapy, durable medical equipment paperwork, and Workers Compensation paperwork.
Performs cash collection and depositing functions as assigned.
Communicates Medical Center administrative and financial policies clearly to patients.
Answers patient account questions and knows when to refer patients to financial counseling, billing agents, patient relations, or other support departments.
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 scheduling and authorization.
Monitors provider(s) open charts and encounters and works with providers to complete encounter documentation in a timely manner.
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.
Provides assistance with complex DME authorizations.
Provides assistance with medication authorization for new medications and refills.
Secures complex insurance authorizations for services, medications, or testing.
Tracks authorizations for renewal based on insurance company driven limits.
Demonstrates competency working with HCPC codes and is able to look up and locate appropriate codes for authorization requests.
Reviews and analyzes monthly denial reports for both professional and hospital billing.
Initiates retro authorizations from denial reports.
Identifies trends in denials and works with the practice team and supervisors to develop and implement improved workflows.
Compiles and analyzes data for reports to track basic revenue cycle measurements.
Creates reports in Microsoft Excel.
Oversees and coaches staff on complex authorization requests.
Addresses patient complaints regarding billing and complaints from Patient Relations.
Tracks patterns of billing complaints and identifies patterns for coaching and education.
Understands the concept of managed care and is knowledgeable about available resources.
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.
Serves as department resource for insurance questions and insurance updates.
Reviews updates with the administrative team and includes important updates in the practice newsletter.
As practice SuperUser, produces reports and reviews cash collection barriers with staff.
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 and pays 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, ensuring it is tidy and has adequate reading and educational materials.
Ensures the reception area temperature is comfortable and seating is adequate.
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 Kiosk use and promotes Kiosk utilization.
Responsible for front end office responsibilities including registration, 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.
Identifies opportunities for productivity improvement and assists management with staff coaching and workflow enhancement.
Able to create Cadence schedule templates for providers.
Ensures templates are user-friendly and promote consistent clinic access.
Able to generate reschedule reports in Cadence and work with 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 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 team members are absent.
Adjusts priorities as required for smooth operation of the practice and notifies clinical staff.
Provides administrative support to providers in coordination of patient care.
Schedules procedures and tests, providing appropriate instructions to patients.
Collaborates with clinical staff in problem-solving patient needs and requests.
Works with 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 multiple clinical symptoms and their associated escalation level.
Provides advanced customer service skills to patients who are medication dependent and may exhibit challenging behaviors.
Understands how to deescalate a difficult encounter and when to seek additional support.
Acts as liaison with Concierge Services, expediting requested services.
Coordinates complex patient care coordination activities.
Arranges appointments and testing, which may include Tumor block genetic testing, Home Care, Physical Therapy, durable medical equipment paperwork, or disability paperwork.
Keeps track of patients who have parallel pathways for their medical care.
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, ensuring accuracy of exam types, location specifications, and insurance restrictions.
Identifies referral problems and reports them to the management team with suggested solutions.
Develops and reviews reports related to referral management, tracking and updating the management team with ongoing referral issues.
Oversight with maintaining Open Access schedules to meet Patient-Centered Medical Home (PCMH) standards.
Performs APEX specific Patient Care Coordinator (PCC) functions as appropriate.
Enters new incoming referrals, including authorization information.
Updates and closes CRM messages and converts CRM messages into telephone encounters.
Opens, documents within, routes, and closes telephone encounters.
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.
Performs advanced appointment scheduling using complex scheduling protocols.
Supports Patient-Centered Medical Home guidelines that require patients have daily available appointment access.
Responds to telephone calls from patients seeking medical care at UCSF Medical Center.
Utilizes the EPIC Appointment Scheduling System (Cadence) to schedule patient appointments.
Documents call information in the EPIC CRM in a concise, accurate manner.
Responds to patient’s online Web appointment requests.
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.
Files all patient-related information, tracks incoming slides, films, and reports.
Returns materials to referring physicians in a timely manner.
Scans and imports patient records and documents in APeX system.
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.
Participates in team building by actively contributing during meetings and discussions.
Attends training classes provided by Medical Center, Billing Agent, and others as necessary.
Works with supervisor and co-workers to ensure the practice responds comprehensively to patient care needs.
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 workload problems and cover vacation or sick leave openings.
Maintains provider calendars.
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.
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.
Serves as practice deputy for life/safety activities and helps lead drills.
Deals directly with patients either by telephone, electronically or face to face while consistently following EVERYDAY PRIDE principles.
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.
Obtains and evaluates all relevant information to handle inquiries and complaints.
Notifies providers of patient delays and service issues.
Acts as an advocate for patients to help facilitate provider punctuality.
Communicates provider delays with the front office team and makes regular announcements to the waiting room.
Offers suggestions for change or improvement in clinic/practice operations.
Leads by example in areas of professional appearance, demeanor, and body language.
Seeks opportunities to improve patient convenience.
Contributes to the development of a patient-focused environment.
Addresses and resolves escalated issues of day-to-day operations.
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.
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 service excellence by following the Everyday PRIDE Guide with UCSF Medical Center standards and expectations.
Uses effective communication skills with patients and staff.
Demonstrates proper telephone techniques and etiquette.
Acts as an escort to any patient or family member needing directions.
Shows sensitivity to differences of culture.
Demonstrates a positive and supportive manner.
Exhibits team work skills to positively acknowledge and recognize other colleagues.
Uses personal experiences to model and teach Living PRIDE standards.
Exhibits tact and professionalism in difficult situations according to PRIDE Values and Practices.
Demonstrates an understanding of and adheres to privacy, confidentiality, and security policies and procedures related to Protected Health Information (PHI).
Demonstrates an understanding of and adheres to safety and infection control policies and procedures.
Assumes accountability for improving quality metrics associated with department/unit and meeting organizational/departmental targets.
Keeps working areas neat, orderly, and clutter-free.
Adheres to cleaning processes and puts things back where they belong.
Removes and reports broken equipment and furniture.
Picks up and disposes of any litter found throughout the entire facility.
Posts flyers and posters in designated areas only.
Knows where the Environment of Care Manual is kept in the department; corrects or reports unsafe conditions.
Protects the physical environment and equipment from damage and theft.
Demonstrates innovation and flexibility regarding the modification of tasks or workflows within assigned duties and job functions.
Performs other duties as assigned.
Performs 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 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.
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
EPIC Appointment Scheduling System (Cadence)
EPIC CRM
Microsoft Excel
Office software (Outlook, Word, Excel)
Basic keyboarding
Customer service
Communication
Interpersonal skills
Basic math
Organizational skills
Problem-solving skills
Writing skills
Administrative/office coordination
Medical practice terminology
Health care experience
Patient scheduling
Insurance verification
Medical record data abstraction
Patient financial services
Appointment scheduling
Ancillary service scheduling
Surgical scheduling
Bi-lingual or multi-lingual capability (Spanish, Cantonese, and Russian)
EPIC

Location

UCSF campus

Work Type

Full-time

Experience Level

4 years related experience (with High School diploma)
6 months related experience (with college degree)

Education Level

High School graduate or equivalent
College degree

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.