UCSD Layoff from Career Appointment: Apply by 8/22/19 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 9/03/19. Eligible Special Selection clients should contact their Disability Counselor for assistance.
Under the direct supervision of the Authorization, Coding and Patient Assistance Manager, the Authorization Coordinator will be responsible for the daily monitoring of oncology referral/authorization work queues. Will be responsible for requesting authorizations, following up on authorization requests, verifying health plan eligibility and coverage, updating registrations, and providing administrative support for all other oncology related billing, denial and appeal issues related to oncology accounts.
The Authorization Coordinator will be responsible for adhering to set expectations, daily/monthly quotas, and timeliness guidelines that have been set by the department manager. Will be required to maintain a high level of detail, accuracy and speed to ensure that productivity levels are met and performance/quality is not compromised. Will be required to maintain professionalism in a high paced and demanding environment.
Will have expert knowledge of UCSD EPIC systems, external health plan provider web portals, Right Fax and other software programs in order to complete tasks efficiently and to research patient accounts if/when needed. Will have an in-depth knowledge of all front end processes, such as: registrations, authorizations, scheduling, coding, and will be able to assist in any of these functions/roles as needed. Will have involvement with patient, third party, government, billing, coding, registration, authorizations, pre-determinations and financial counseling/patient assistance activities.
Will provide support for coordinated processes, procedures and systems, customer service delivery models and ensuring compliance with internal policy and external agency regulations. Will work collaboratively with clinical care and finance teams to ensure the financial stability of UC San Diego Health System. Will keep abreast of the full array of third-party contracts and requirements, health plan/IPA contracts and ICD-10/HCPCS code changes. Assists with proper screening and routing of patients requiring financial counseling.
Will have the ability to read and analyzing operative and progress notes to determine appropriateness and medical necessity to support services being ordered. Will verify that medical necessity guidelines have been met prior to clearing an account/referral. Will be required to have a high level of critical thinking skills and be expected to work with minimal supervision to respond to and resolve issues related to authorization, reimbursement, finance, registration and/or coding issues related to oncology accounts.
The role includes daily monitoring of EPIC Referral WQ's, incoming and outgoing faxes and phone calls. Will also provide support to departmental leadership, staff and faculty. Utmost sense of professionalism and discretion. Ability to execute tasks and multi-task effectively with minimal supervision. Ability to complete projects, and manage deadlines and expectations with minimal supervision. Will assist with strategizing best way to streamline the ancillary authorization workflow and work queue.
Will provide support as needed to departmental leadership, staff and faculty. Will be required to cross-cover in other administrative areas related to oncology. Will function as an expert for the department and serve as a liaison between the Medical Center, Medical Group, Cancer Center La Jolla, and Encinitas Cancer Center Business Offices with minimal supervision with flexible approach to manage shifting priorities and work schedule. Job standards to be performed at the EXPERT level.
Three (3) years of directly related experience in a large complex healthcare or clinic setting; or an equivalent combination of education and experience.
Demonstrated knowledge of medical terminology and coding.
Proven organizational and project management skills, determinate priorities, complete multi projects, and high level of attention to detail while working with conflicting deadlines.
Must possess excellent communication skills, both written and verbal.
Previous experience in a clinical setting.
Previous EPIC/Cadence experience.
CPC and/or CHONC coding certification.
Must be able to work various hours and locations based on business needs.
Employment is subject to a criminal background check and pre-employment physical.
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