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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 recovery. This role provides support to all 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 demonstrating sensitivity to the needs of patients, staff, and providers. This position makes a difference for patients by providing excellent customer service and ensuring accurate information flow to maximize unit efficiency. The PC is required to work at any UCSF campus as needed.

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 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 scheduling problems to supervisor.
• Collects and verifies insurance and referral/authorization information for first appointments.
• 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, required records, and provides other requested information to patients.
• Gives directions and instructions to patients before the first appointment.
• Manages patient expectations by providing practice-specific guidelines.
• Secures outside medical records, CD’s of scans and pathology slides, reviewing them for completeness.
• Determines which physician can best evaluate the patient based on secured records.
• Prioritizes new patient scheduling based on diagnosis and current treatment status.
• Informs patients about possible treatment scheduling options, clinical trials, and coordinates screening with research personnel and physicians.
• Consults with appropriate departments to coordinate care for patients who would benefit from other clinical disciplines.
• Meets with new patients after their visit to explain care coordination, clinical trials, testing, surgical procedures, and care within other departments.
• Coordinates scheduling of all outpatient and inpatient surgeries for the surgical practice.
• Ensures surgical procedures are scheduled within a clinically appropriate timeframe.
• Interfaces with patients, physicians, and hospital staff to ensure adequate communication regarding surgical services.
• Coordinates surgical activities with physician’s other responsibilities.
• Processes complex hospital admission forms, schedules pre-surgical tests and appointments, and secures necessary resources and equipment for surgery.
• Manages complex scheduling coordination for 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 surgery in Op-Time.
• Manages complex admission, discharge, and planning coordination 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 and ensures compliance with hospital policies.
• Secures authorization for surgical procedures and coordinates with Hospital Admissions Department.
• Communicates with the surgeon post-surgery to confirm any additional procedures and amends authorization with the insurance company.
• 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 by reviewing outside studies and pathology.
• Ensures appropriate and timely communication and documentation with the patient and physician.
• Secures surgical consent for cosmetic services, including identification of cases, pricing, and payment coordination.
• Analyzes pricing structure to ensure competitiveness and updates as needed.
• Arranges post-surgical appointments and testing, including Home Care, Physical Therapy, durable medical equipment paperwork, and Workers Compensation.
• Performs cash collection and depositing functions as assigned, complying with policies and procedures.
• Communicates Medical Center administrative and financial policies clearly to patients, answering account questions.
• Refers patients to financial counseling, billing agents, patient relations, or other support departments when necessary.
• Obtains and documents insurance authorizations for established patient visits, referrals, and procedures or ancillary services.
• Communicates clinical information from medical records to 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 documentation.
• 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 requiring specific documentation.
• Provides assistance with medication authorization for new medications and refills.
• Secures complex insurance authorizations for services, medications, or testing and tracks them for renewal.
• Demonstrates competency working with HCPC codes and locating appropriate codes for authorization requests.
• Understands and interprets a patient’s insurance benefit package, including pharmacy and mental health carve outs.
• Reviews and analyzes monthly denial reports for 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.
• 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 trends for coaching and education.
• Understands managed care concepts and resources available for specific plan requirements.
• Assists patients in understanding managed care concepts.
• Reviews upcoming visits to determine patient eligibility and assists with transitioning patients who are no longer eligible.
• Acts as a department resource for insurance questions and updates.
• Greets and welcomes patients using AIDET standards.
• Determines patient co-pay obligations and collects them at the time of visit.
• Collects payments on patient accounts.
• Prioritizes timely registration of patients on check-in and maintains practice flow.
• 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 has adequate seating.
• Observes the waiting area and performs customer service intervention for long waits or inadequate service.
• Assists patients with Kiosk use and promotes Kiosk utilization.
• Responsible for front-end office responsibilities including registration, referral processing, authorization coordination, cash deposits, DME oversight, and scheduling.
• Acts as a Care Support Assistant for the DSRIP funded clinical team.
• Develops and analyzes front desk productivity reports to improve co-pay collection rates and payer plan capture.
• Identifies opportunities for productivity improvement and assists management with staff coaching and workflow enhancement.
• Able to create Cadence schedule templates for providers.
• Ensures template construction promotes user-friendliness and consistent clinic access.
• Able to generate reschedule reports in Cadence and work with the administrative team to ensure timely rescheduling.
• Schedules established patient appointments using Apex and its related components.
• Understands the distinction of each medical practice and how care is delivered.
• 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 practices and ancillary service staff.
• Provides prompt and convenient appointment access to patients.
• Adheres to provider productivity standards as established in APEX templates.
• Schedules appointments with the appropriate appointment type.
• Triage all telephone calls, screening for emergencies and routing messages and requests.
• 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 team members are absent.
• Adjusts priorities as required for smooth practice operation 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.
• Assists in maintaining current filing and scanning.
• Understands multiple clinical symptoms and their associated escalation level.
• Provides advanced customer service to patients who are medication dependent and may exhibit challenging behaviors.
• De-escalates difficult encounters and seeks support from leadership when necessary.
• Acts as liaison with Concierge Services, expediting requested services for urgent requests.
• Coordinates complex patient care activities, including appointments, testing, and paperwork for various needs.
• Keeps track of patients with parallel pathways for medical care and works with clinical providers.
• Books Radiology/Cardiology appointments directly into scheduling software, ensuring accuracy.
• Identifies referral problems and reports them to the management team with suggested solutions.
• Develops and reviews reports related to referral management.
• Maintains Open Access schedules to meet Patient-Centered Medical Home (PCMH) standards.
• Performs APEX specific Patient Care Coordinator (PCC) functions.
• Enters new incoming referrals and authorization information.
• Updates and closes CRM messages and converts them 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.
• Encourages use of the check-in kiosk and troubleshoots technical or customer service issues.
• Pends orders (including med refills, referrals, procedures) and routes to provider for review.
• Pends Smart Sets with proper orders and diagnosis and routes to provider for review.
• Modifies order class of labs.
• Performs advanced appointment scheduling using complex protocols.
• Supports Patient-Centered Medical Home guidelines for daily available appointment access.
• Responds to telephone calls from patients seeking medical care.
• Utilizes the EPIC Appointment Scheduling System (Cadence) to schedule patient appointments.
• Documents call information in the EPIC CRM concisely and accurately.
• Converts CRM messages to telephone encounters according to practice guidelines.
• Responds to patient’s online Web appointment requests.
• Utilizes Phone Bank protocols to determine when to involve a clinician on a call.
• 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.
• Maintains and adheres to patient confidentiality and HIPAA guidelines.
• Participates in team building by actively contributing during meetings.
• Attends training classes and applies information on the job.
• Works with supervisor and co-workers to ensure the practice responds to patient care needs.
• Complies with all Medical Center and Ambulatory Services procedures for infection control, safety, administrative, and clinical practice.
• Fills in for other co-workers to help address workload problems and cover 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.
• Complies with infection control policies.
• Serves as practice deputy for life/safety activities.
• Deals directly with patients either by telephone, electronically or face to face.
• Responds promptly and courteously to internal and external inquiries.
• Stays logged into appropriate APeX Pools and In Baskets.
• Handles front-line patient complaints with support from the Practice Supervisor / Administrative Director.
• Supports all performance improvement initiatives.
• Obtains and evaluates all relevant information to handle inquiries and complaints.
• Notifies providers of patient delays and service issues.
• Acts as advocate for patients to help facilitate provider punctuality.
• Communicates provider delays with the front office team and makes announcements to the waiting room.
• Offers suggestions for change or improvement in clinic/practice operations.
• Leads by example in 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 and lead process improvement 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.
• Demonstrates service excellence by following the Everyday PRIDE Guide.
• Uses effective communication skills with patients and staff.
• 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.
• Demonstrates an understanding of and adheres to privacy, confidentiality, and security policies.
• Demonstrates an understanding of and adheres to safety and infection control policies.
• Assumes accountability for improving quality metrics.
• 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 facility.
• Posts flyers and posters in designated areas only.
• Knows where the Environment of Care Manual is kept and 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.
• 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.
• 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.

Skills

• APeX
• CRM messages
• Telephone encounters
• Referrals
• APeX in-baskets
• Scanning
• Filing
• Authorizations
• Billing
• EPIC Appointment Scheduling System (Cadence)
• EPIC CRM
• Microsoft Excel
• CPT codes
• ICD-9
• ICD-10
• HCPC codes
• Office software (Outlook, Word, Excel)
• Customer service
• Communication
• Interpersonal skills
• Organizational skills
• Problem-solving skills
• Writing skills
• Administrative/office coordination
• Medical practice terminology
• Cash collection
• Tumor block genetic testing
• Home Care
• Physical Therapy
• Durable medical equipment
• Workers Compensation
• Radiology scheduling software
• Syngo
• MUSE
• Patient-Centered Medical Home (PCMH)
• DSRIP
• AIDET
• HIPAA
• Everyday PRIDE principles

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

• UCSF Medical Center is a patient-focused organization dedicated to enhancing health and well-being 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 committed to the values of professionalism, respect, integrity, diversity, and excellence.