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.
Ranked by U.S. News & World Report as the number one hospital in California - and among the top five in the country - 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.
Under the direction of the Revenue Manager and Assistant Director, the incumbent will work independently and have the primary responsibility to manage the authorization workflow for office visits/ in-office procedures, surgical cases, and radiological exams across multiple areas of the medical center. He/She must have a strong foundation in healthcare and be familiar with medical terminology, processes and work flow of patient accounting in order to make good decisions and resolve account issues. He/She must have the ability to perform, prioritize multiple tasks and work well with all levels of faculty, management, and staff.
The incumbent must have a minimum of three of experience with working with HMO, commercial, Medicare, Medi-Cal, and Workers compensation insurances. He/She will be responsible for working with providers and clinic staff, as well as patients on complex cases. He/She will be working billing work queues (WQ) on a daily basis as well as working authorization requests either through the phone, on line, or via e-mail.
The incumbent will be expected to speak with patients regarding questions they may have, direct patient calls to appropriate areas as well as follow up with questions regarding authorizations and or insurance issues. He/She will be responsible for verifying accurate information in order to obtain authorizations as well as ensure reimbursement and if needed, update systems and notify appropriate department for future follow up.
The incumbent will be expected to investigate highly complex cases and evaluate alternative funding sources for patients in need, and propose procedures and systems in support of efficient workflows and maximization of reimbursement. He/She should have outstanding people skills, including telephone technique, professional appearance, organizational, and communication skills (oral and written), be independent, self-motivated, and have problem solving skills.
This position requires attendance and completion of UCSF on-line and in class courses including, but not limited to HB/PB APeX, Basic Insurance Concepts and collecting Patient Information training.
* Minimum three years of experience in billing and / or collections processes, concepts, systems and external regulations
* Bachelor's degree in related area and / or equivalent experience / training
* Knowledge of medical terminology and coding
* Knowledge of the regulations and confidentiality issues involved in the revenue side of medical care, including private and government insurance, self-pay, collections, and reporting and data management
* Knowledge of database, spreadsheet and presentation software
* Analytical and problem-solving skills, with the ability to learn to evaluate workflows and systems
* Detail oriented, with organizational skills and the ability to manage time efficiently, prioritize tasks, and complete assignments consistently on schedule
* Basic communications skills, with the ability to interpret and present clinical financial information clearly and concisely
* Interpersonal skills to work effectively in a team environment with internal staff in a wide variety of business and clinical areas
* Ability to provide recommendations on issues of functionality and operations in billing, and to serve as a resource, providing expertise and education to staff and management at all levels
* The flexibility to orient and work at all UCSF Medical Center locations
* CPC certificate
* Apex system experience, Microsoft office word and excel experience
Living Pride Standards
* Demonstrates service excellence by following the Everyday PRIDE Guide with the UCSF Medical Center standards and expectations for communication and behavior. These standards and expectations convey specific behavior associated with the Medical Center's values: Professionalism, Respect, Integrity, Diversity and Excellence, and provide guidance on how we communicate with patients, visitors, faculty, staff, and students, virtually everyone, every day and with every encounter. These standards include, but are not limited to: personal appearance, acknowledging and greeting all patients and families, introductions using AIDET, managing up, service recovery, managing delays and expectations, phone standards, electronic communication, team work, cultural sensitivity and competency.
* 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 in which patients / families/ colleagues perceive interactions as positive and supportive. Exhibits team work skills to positively acknowledge and recognize other colleagues, and 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) or other sensitive and personal information.
* 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, including the hallways. 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 entire facility.
* Posts flyers and posters in designated areas only; does not post on walls, doors or windows.
* Knows where the Environment of Care Manual is kept in department; corrects or reports unsafe conditions to the appropriate departments.
* Protects the physical environment and equipment from damage and theft.
The flexibility to orient and work at all UCSF Medical Center locations is required.
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. Further information about the University of California, San Francisco, is available at diversity.ucsf.edu. UCSF seeks candidates whose skills, and personal and professional experience, have prepared them to contribute to our commitment to diversity and excellence, and the communities we serve.