Practice CRD 2

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 2 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: CRM messages, telephone encounters, referrals, APeX in-baskets, scanning, filing, authorizations, and billing.

The PC 2 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 PA 2 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 PC2 is required to work at any UCSF campus as needed and scheduled.

• Day shift Responsibilities New Patient Scheduling and Processing 10 %
• On a daily basis reviews and works referral workqueues documenting activities within the referral record.
• Acts as one of the primary contact for referring physicians and patients.
• If practice utilizes a mirror system for external referrals, such as an electronic log, maintains electronic log but also creates referral record for accurate tracking and documenting of external referrals.
• Assigns new Integrative Chinese Medicine (ICM) and massage patients to providers as required, taking into account scheduling issues.
• Schedules and registers patients by telephone or in person before first appointment meeting established accuracy and performance standards. Provides new patients with 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 supervisor.
• Collects and verifies insurance and referral/authorization information for first appointment ensuring referral records and Hospital Accounts Records (HARS) are created and assigned to the appointment.
• Schedules and coordinates any pre-appointment tests or appointments.
• Explains ICM and Massage first appointment procedures in layman’s terminology to patient including required records prior to the first visit; prepares and mails New Patient Packet or sends through MyChart; provides other information requested by 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. Revenue Cycle 10 %
• Performs cash collection functions as assigned, complying with all established policies and procedures.
• Communicates Medical Center administrative and financial policies clearly to patients, answering patient account questions and knowing when to refer patients to financial counseling, billing agents, patient relations or other support departments for additional help.
• Guides patients through the process of obtaining 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 guiding patients to obtain their authorizations.
• 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. Moderate Complex Revenue Cycle 5 %
• Works RFI workqueues to secure information for accurate billing submissions or to respond to denials such as retro authorizations, clinical documentation, and addended authorizations with add on CPT codes.
• Assists with authorizations for specialty visits and ancillary testing and coordinates with Hospital Admissions Department as needed. Check in / Front Desk: 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 (if available onsite) and actively works to promote Kiosk utilization. Cadence Template 5 %
• Understands how template construction effects access and works to ensure templates are user friendly and help promote consistent clinic access.
• Able to generate reschedule reports in Cadence and work with other members of administrative team to ensure patients are rescheduled in a timely manner to avoid customer service problems. Administrative and Patient Care Coordination Responsibilities 25 %
• 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.
• Has a keen awareness of the need to provide prompt and convenient appointment access to patients.
• Adheres to the provider productivity standards as established in APEX templates for the practice and schedules appointments with the appropriate appointment type.
• Triages 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.
• Demonstrates an ability to adjust 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. Moderate Complex Administrative and Patient Care Coordination Responsibilities 5 %
• Must have an understanding 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.
• Advanced customer service skills in working with and providing exceptional customer service to patients who are medication dependent and may exhibit challenging behaviors. This includes understanding how to deescalate a difficult encounter and also when to seek additional support from leadership and to protect the safety of the work environment. APeX and IT Specific Skills 5 %
• Performs the following APEX specific Patient Care Coordinator (PCC) functions as appropriate to completion of APeX PCC training and job duties: o Enter new incoming referrals; entering authorization information as appropriate o Updating and closing CRM messages and converting CRM messages into telephone encounters if practice is serviced by the Ambulatory Services Call Center o Open, document within, route and close telephone encounters. Able to accurately utilize documentation steps when leaving a telephone encounter open pending further communications with the caller o Works applicable APeX workqueues to address patient care and service matters o Create and send administrative communications via MyChart o Create SmartPhrase templates associated with administrative functions o Open, document within, route and close telephone encounters. Able to accurately utilize documentation steps with leaving a telephone encounter open pending further communications with the caller. Able to utilize smart text logic to document patient phone screening as associated with complex appointment scheduling. o Works applicable APeX workqueues to address patient care and service matters o Encourage use of the check-in kiosk (if available) and trouble shoot technical or customer service issues
• Moderate Complex APeX and IT Specific Skills 5 % o Pend orders (including med refills, referrals, procedures etc.) associated with a diagnosis and route to provider for review and signature (from preference list only) o Pend Smart Sets with proper orders and diagnosis and route to provider for review and signature o Modify order class of labs from lab collection vs. clinic collection or UCSF Collect vs. External Collect. o Perform advanced appointment scheduling using complex scheduling protocols from a variety of ancillary and subspecialty services some of which will require authorization. o Support Patient-Centered Medical Home, Standard 1 guidelines that require patients have daily available appointment access to the practice and if no appointments are available coordinate them at another site or within Adult or Pediatric Urgent Care. Phone Bank 20 %
• 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.
• Is able to convert 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. General Performance
• As assigned, 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. Bring information back to practice and use 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 The Joint Commission and Title 22 standards.
• As assigned, fills in for other co-workers to help address work load problems and cover vacation or sick leave openings. Moderate Complex General Performance:
• Provides 1:1 and team training for new hires and new initiatives and procedures Environmental

• Reports Required Qualifications 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. 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 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 Pend orders Pend smart sets Schedule surgeries Work applicable work queues Enter/edit outside test results Messaging (CRM) if applicable 2nd 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

• Demonstrated experience in health care (may include medical, dental or veterinary) in the following areas: patient scheduling, insurance verification, medial 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/APeX.