PRACTICE CRD 2

JOB SUMMARY

Under direct supervision and guided by the procedures of UCSF Dental Center, the Practice Coordinator II is responsible for providing support to the UCSF Oral Medicine Clinic. The Practice Coordinator II/ Treatment Planning Coordinator primary responsibility is managing patient appointments for the Oral Medicine Clinic, the incumbent can act in all capacities of the administrative team including but not limited to: Front desk or Scheduling, insurance verification, requesting pre-authorizations, treatment plan coordinating and managing billing and collections in partnership with the DC's Patient Billing Services (PBS). The Practice Coordinator is the direct liaison between patients and the services they receive at the clinics at any level of care.
The Practice Coordinator II works as a team member and consistently projects a professional and courteous demeanor. The Practice Coordinator II is required to comply with UCSF and School of Dentistry standards and to demonstrate excellent customer service skills with patients and staff. The Practice Coordinator II must have the ability to perform and prioritize multiple tasks and work well with staff, students, patients, and providers.
The Practice coordinator is required to work at any clinic locations as needed and scheduled. This may include weekends and evenings. The incumbent may also support other Dental Center clinics as needed.

None

DUTIES & ESSENTIAL JOB FUNCTIONS

• 60% - Administrative and Patient Care Coordination Responsibilities and Check in/Front Desk*

  * Greets and welcomes patients.
  * Observes the waiting area and performs customer service intervention when patients have been waiting a long time or are not receiving adequate service.
  * Collects and verifies insurance and referral/authorization information for each appointment, and request a pre-authorization when applicable, ensuring referral records are created and assigned to the appointment.
  * Responds to telephone calls, emails and fax messages from patients seeking care at UCSF Dental Center and partners of care.
  * Registers patients by telephone or in person before first appointment; meeting established accuracy and performance standards. Completes appropriate practice intake paperwork and follows established practice guidelines to ensure new patients are seen within prescribed timelines.
  * Schedules established patient appointments using APeX and its related components. Communicate any problems with the schedule with supervisor.
  * Understands the distinction of each dental practice and how care is delivered in each setting.
  * Coordinates appointments with multiple providers as required. Follows-up on cancelled and no-show appointments, in coordination with provider.
  * Discusses practice policies and procedures with patients and referring physicians.
  * Answers questions about provider schedules and act 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.
  * Responds to telephone calls from patients seeking care at UCSF Dental Center, clinics and 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.
  * Submits and follows up on insurance pre-authorizations and communicate outcome (approval / denial) with providers.
  * Schedules and coordinates any pre-appointment tests or appointments.

  * Gives directions and instructions to patients before their appointment. Manages patient expectations by providing practice-specific guidelines related to service/visit. Seeks clinical input when appropriate.
  * Understands and is able to prioritize new patient scheduling based on diagnosis.
  * 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.
  * Advanced customer service skills in working with and providing exceptional customer service to patients who may exhibit challenging behaviors. This includes understanding how to de-escalate a difficult encounter and when to seek additional support from leadership to protect the safety of the work environment.
  * Demonstrates courtesy and overt helpfulness in all interactions. Collaborates with Practice Supervisor and Administrative Manager in the resolution of patient complaints.
  * Determines a patient's copay obligation for scheduled treatment. Attempts to collect patient outstanding balance for the Dental Center at the time of the visit.
  * Ensures that front end clinic workqueues in APeX, including Referral-Consult In and Missing Registration, are consistently worked on and are maintained within DC's service levels.
  * Understands and follows the University Cash Handling Guidelines; including preparing daily deposits and ensuring funds are balanced and reconciled at the end of each day. Coordinates closely with the billing team as needed on deposits and insurance-related questions as needed for patients.
  * Provides support to other Dental Center clinics as needed.
  * Other Duties as assigned.

• 10% - Patient Information Coordination

  * Creates a professional and positive first impression for patients and referring physicians. Demonstrates good judgment and common sense.
  * Manages patient expectations by providing practice-specific guidelines related to service/visit.
  * Obtains appropriate Consents and signed documents at first visit and as required.
  * Coordinates treatment plans with providers and patients in Oral Medicine. Assists in coordinating treatment and appointments with other clinics in the Dental Center and UCSF Health.
  * Reconciles missing charge report (MCR) for all arrived services according to established procedure. This includes a review of the practice arrival list to ensure that documentation and charges are triggered for all billable patient care services.
  * Primary liaison to monitor and resolve any inquiries routing to the "Request For Information" (RFI) work queue related to patient complaints, authorization denials, appeal letters for medical necessity, etc to ensure timely claim submission and minimize aging accounts receivable for the practice, in partnership with PBS.
  * Maintains and adheres to patient confidentiality and HIPAA guidelines including the distribution of NOPPs (Notice of Privacy Practices) and PAFR (Patient Financial Agreement)

• 20% - Communication & Safety

  * Triages phone calls, screening for emergencies and routing all referral request messages.
  * Triages questions pertaining to insurance and billing to the Patient Billing Unit and acts as a resource to other medical center practices and ancillary service administrative staff.
  * Educates patient of personal financial responsibility and expectations of patient at the time of service.
  * Provides patient consultations and communicates information about recommended treatment(s) and/or appliance options.
  * Discusses cost of service, insurance or Medi-Cal coverage, out-of-pocket costs and payment options with patients, cost breakdowns, prepares and obtains a signed contract and enter appropriate financial data in the EHR. Ensures patients understand their financial liability prior to treatment.
  * Communicates UCSF Dental 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.
  * Assists patients attempting to apply for Financial Need and/or escalates complex questions to the supervisor for further follow up.
  * Nurtures the patient relationship to encourage patient retention and contribute to the development of a patient-focused environment.

• 10% - Communication & Safety

  * Upholds UCSF's policy regarding the maintenance and confidentiality of medical records and other patient information.
  * Demonstrates courtesy, cheerfulness and overt helpfulness in all interactions.
  * 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 UCSF 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, and proactively where possible, 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 School of Dentistry/Dental Center procedures for infection control, safety, administrative and clinical practice.
  * As assigned, fills in for other co-workers to help address workload problems and cover vacation or sick leave openings.
  * In collaboration with Oral Medicine Director, manages patient distribution to residents following initial consults prior to records appointment.
  * Populate resident and faculty coverage and vacations in EHR clinic schedule grid.
  * Demonstrates an ability to adjust priorities as required for smooth operation of the practice.
  * Upholds waiting room standards, including masks, reading material as well as education materials in all waiting areas.
  * Complies with recommendations made by ergonomic specialists to avoid workplace injury.

* High School graduate or equivalent with 4 years related experience; or college degree and 6 months related experience; or equivalent combination of education and experience with appointment scheduling.
* Strong knowledge and experience in medical insurance billing, including verifying insurance eligibility, understanding benefits, and managing authorization processes such as requesting pre-authorizations.
* Ability to analyze situations, prioritize, and develop solutions, and make recommendations.
* Ability to work independently at the reception desk.
* Ability to use good judgment and work independently at times under the pressure of deadlines.
* 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.
* Strong computer skills, including basic keyboarding skills, and experience with Microsoft Word and Excel.
* Proven ability to deal with a wide variety of individuals.
* Ability to deal sensitively and effectively with ill 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 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.

• N/A

* High School graduate or equivalent with 4 years related experience; or college degree and 6 months related experience; or equivalent combination of education and experience with appointment scheduling.
* Strong knowledge and experience in medical insurance billing, including verifying insurance eligibility, understanding benefits, and managing authorization processes such as requesting pre-authorizations.
* Ability to analyze situations, prioritize, and develop solutions, and make recommendations.
* Ability to work independently at the reception desk.
* Ability to use good judgment and work independently at times under the pressure of deadlines.
* 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.
* Strong computer skills, including basic keyboarding skills, and experience with Microsoft Word and Excel.
* Proven ability to deal with a wide variety of individuals.
* Ability to deal sensitively and effectively with ill 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 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.

• N/A