Practice Coordinator 3

JOB SUMMARY

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 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. S/he provides support to all functions of the administrative teams including but not limited to: 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.  S/he 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.  S/he is a self-reliant individual who synthesizes his/her knowledge of practice operations in order to problem-solve, prioritize and facilitate complex transactions in the course of his/her 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

DUTIES & ESSENTIAL JOB FUNCTIONS

Advanced Administrative and Patient Care Coordination Responsibilities 60%

• Acts as liaison with Concierge Services. Expedites requested services.

   

• Coordinates/schedules new complex patient care coordination activities. Arranging appointments

and testing

• 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. May create and maintain APeX patient lists or Excel Spreadsheets for tracking purposes. 

• Is skilled and able to book appointments directly into Apex resource room and provider schedule 

while ensuring accuracy of exam types, location specifications and insurance restrictions.

• Identify referral problems; report out to management team with suggested solutions.
•  
• Develop and review 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 {could include Direct Access scheduling into the generic job template)

Customer Service Outreach 20%

• 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 Manager/ 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

   

• S/he is a strong team player, has a dedicated work ethic, and is willing to learn and adapt to new

tasks when asked. 5/he is comfortable building rapport with patients quickly and is able to work effectively with and without supervision and remain calm and friendly in all interactions with patients

• Notifies providers of patient delays and service issues. 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.

   

• S/he 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.

            Living Pride Standards

Advanced Revenue Cycle 10%

• Secures complex insurance authorizations for services, medications, or testing and is able to track

the authorizations for renewal based on insurance company driven limits of time frames or numbers of visits or services.

• Has demonstrated competency working with HCPC codes and is able to look up and locate the

appropriate codes for the purpose of requesting authorization (e.g. J codes for medications like chemotherapy).

• Understands how to identify and interpret a patient's insurance benefit package, including

pharmacy and mental health carve outs. Utilizes this information to direct authorization requests and to coordinate these services for patients.

• Reviews & analyses monthly denial reports for both professional and hospital billing. Initiatives

retro authorizations from denial report.

• Identifies trends in denials and works with 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. and creates reports in Microsoft Excel.

• Oversees and coaches staff on complex authorization requests as they arise.
•  
• Address patient complaints from patients regarding billing and complaints related to billing that

come out of Patient Relations.

• Through reporting track patterns of billing complaints and identify 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 in regards to knowing the specific requirements of individual managed care plans. Assists patients to understand the concept of managed care.

• Reviews all upcoming visits to determine patient eligibility and assists with transitioning patients

who are no longer eligible to new primary care practices through collaboration with the practice Social Worker and clinical teams.

• Department resource for insurance questions and insurance updates, including having reserved

time on the staff agenda to review updates with administrative team, include important updates in the practice newsletter including drafting newsletter announcements

• As practice Superuser will produce reports and review with staff cash collection barriers to improve

cash collection rates for the practice.

Check in / Front Desk Coverage: 10 %

• 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 and is aware of the necessity of maintaining practice flow, paying careful attention to the 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

Service Excellence

1. 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.   
2. 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. 

Work Environment

• 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.

OTHER FUNCTIONS AND RESPONSIBILITIES

• Demonstrates innovation and flexibility regarding the modification of tasks or workflows within assigned duties and job functions

• Required to participate in LEAN management activities to include attending daily huddles and monthly leadership rounds

• Perform other duties as assigned

• Other clerical duties as assigned.

Qualifications

QUALIFICATIONS

REQUIRED

• 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 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. 
• Able to sit at a computer terminal with telephone headphones for extended periods of time. 
• 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/process improvement 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
  • Work applicable work queues
  • Messaging (CRM)       if applicable
  • 2^nd 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

Preferred Qualifications:

• Bachelor’s Degree in Health Science or equivalent
• 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. 
• Lean certification 

Required Licenses/Certifications:

• N/A 

POPULATIONS SERVED

Child, Adolescent, and Adult