Practice CRD 3

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 3 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 3 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 3 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.

This PC 3 position functions in the outpatient clinical settings at all UCSF Health sites (Mission Bay, Mt. Zion, joint UCSF health partnerships, Satellite Clinics, or with UCSF Faculty at other off-site clinic sites, et al).

• Day shift Responsibilities % of time Essential Function (Yes/No ) Key Responsibilities (To be completed by Supervisor) 2 Advanced New Patient Scheduling and Coordination
• Secures outside medical records, CD’s of scans and pathology slides; reviewing them for completeness; and making a determination as to which physician can best evaluate the patient.
• Understands and is able to prioritize new patient scheduling based on diagnosis and current treatment status to ensure complex patients are scheduled according to practice priorities (e.g. someone newly diagnosed with Stage IV colorectal cancer is seen within the week vs. a second opinion currently receiving treatment is seen within 3 weeks).
• Informs patients about possible treatment scheduling options, clinical trials and screening is coordinated with appropriate research personnel and the appropriate physician. As indicated upon screening, if the patient would benefit from a consultation with other clinical disciplines consults with the appropriate department and will work to coordinate care, to optimize schedules, and expedite services.
• At new patient visits, as appropriate meets with patient after the visit to explain how care is coordinated with possible clinical trials, testing, surgical procedures and care within other departments (e.g. general surgery, cardiology) and with other external providers 0 Advanced Surgery Scheduling
• Coordinates pre-operative anesthesia appointments with other testing, authorization coding and scheduling the surgery in Op-Time. Additionally many cases require complex admission, discharge and planning coordination involving hospital reservations and authorizations related to 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 to ensure compliance with all hospital policies and procedures.
• Secures authorization for surgical procedures and coordinates with Hospital Admissions Department as needed. Communicates with the surgeon post-surgery to confirm if any additional surgical procedure was performed and if so to follow up with the insurance company immediately to amend the authorization. Acts as primary liaison to procedure billing team to coordinate updated authorizations and or TARs for mid procedure changes or additions.
• Ensures compliance with Medical Center bylaws and Regulations ensuring the diagnosis is confirmed before treatment is offered through formal review of any and all outside studies and pathology. The coordinator is the sole person to ensure appropriate and timely communication and documentation with the patient and the physician.
• Successfully interacts with patients to secure surgical consent for cosmetic services. This includes identification of cases, cosmetic price guidelines, quote prices and coordinate payment. Analyze the pricing structure to ensure that the prices remain competitive and are updated as needed. This position is expected to represent UCSF Medical Center’s objective to grow elective cosmetic services by providing sophisticated customer service and sales
• Arranging post-surgical appointments and testing, which may or may not include Home Care, Physical Therapy, starting paperwork for durable medical equipment and following up on all other paper work, i.e. Workers Compensation as necessary. 5 Moderate Complex Revenue Cycle
• Monitors provider(s) open charts and encounters and works with providers to complete encounter documentation in a timely manner to support revenue cycle workflow. May assist 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 such as retro authorizations, clinical documentation, and addended authorizations with add on CPT codes.
• Secures authorization for procedures, specialty visits and ancillary testing and coordinates with Hospital Admissions Department as needed.
• Provide assistance with complex DME authorizations that often require precise documentation in specific formats to receive approval
• Provide assistance with medication authorization for new medications and refills. 35 Advanced Check in/ Front Desk
• Responsible for front end office responsibilities to include but not limited to functions ranging from registration and front desk duties, referral processing, authorization coordination and review, cash deposits, DME oversight and scheduling functions. S/he will also act 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 to improve co-pay collection rates and accurate payer plan capture. Identifies opportunities for productivity improvement and assists management team with staff coaching and workflow enhancement.
• Is primarily responsible for representing the clerical team as the public face and works closely with the administrative 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 to include: message boards, referrals, Apex in-baskets, scanning and filing. 0 Cadence Template Builder
• Able to create Cadence schedule templates for providers
• Understands how template construction effects access and works to ensure templates is 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. 20 Administrative and Patient Care Coordination Responsibilities
• 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. 20 APeX and IT Specific Skills
• 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. 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 Create and send administrative communications via MyChart o Create SmartPhrase templates associated with administrative functions o Create and route patient letters associated with administrative matters o Perform enter/edit outside test results following established workflow and steps 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 and trouble shoot technical or customer service issues 10 Phone Bank
• 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. 2 Moderate Complex General Performance
• Maintains provider calendars
• When working in a primary care practice, assists with the delivery and maintenance of a high standard of patient care using the Patient Centered Medical Home model which emphasizes the care of the “whole patient” which includes in-reach, outreach and intensive follow up on referrals.
• When working within the primary care environment acts as the coordinator for all of patient’s needs such as forms (ie. work release, disability, immunization records, etc.) and is principally responsible for the continuity of care for patients which includes a significant amount of support for patients at the time of the visit and between visits.
• Provides 1:1 and team training for new hires and new initiatives and procedures 3 Environmental Responsibilities
• Reports any malfunctioning of equipment.
• Complies with recommendations made by ergonomic specialists to avoid workplace injury
• Complies with infection control policies related (e.g. does not eat at the front desk or in patient care areas) 6 Customer Service Outreach
• 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 Supervisor / 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 REQUIRED QUALIFICATIONS Identify the minimum skills, knowledge and abilities required to competently perform the job duties. Please complete this section in bullet form and include suggested minimum years of related experience, e.g., "Previous experience in healthcare or health insurance environment required (usually 3-5 years)" or "Five to seven years project management experience". This section should include the required educational background, work experience, skills, knowledge and abilities. These qualifications will be included in the job posting and will be used to screen applicants. Flexibility statement below is required for all Medical Center positions. 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. This position requires flexibility to orient and work at all UCSF Medical Center locations. Apex/EMR experience Strong knowledge or experience related to healthcare Experience/knowledge of commercial and government payors Strong knowledge/experience with advanced authorization work Experience in a Customer Service role PREFERRED QUALIFICATION Apex knowledge Prior experience related to customer service Prior experience in the health care industry Past insurance/authorization experience related to CPT and ICD10