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, clncal and management teams to support practice operations and customer service recovery and intervention efforts Provides support to all functions of the adminstrative teams including but not limited to CRM 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 Adheres to the UCSF House and Telephone Standards and is sensitive to the needs of patients, staff and providers at alltimes The PC is a team player who works closely with others and who is flexible in dealing with the changing priorities Requires a self reliant individual who synthesizes knowledge of practice operations in order to problem-solve, prioritize and facilitate complex transactions in the course of daily activities.

This position makes a difference for patients in an outpatient care unit by providing excellent customer service, faclitating 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.

New Patient Scheduling and Processing 5 %
On a daily basis reviews and works referral workqueues documenting activities within the referral
record
Acts as the primary contact for referring physicians and new 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 patients to providers as required, taking into account scheduling issues
Schedules and registers patients by telephone or in person before first appointment meeting
establshed accuracy and performance standards Completes appropriate practice intake
paperwork and follows establshed 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 first appointment procedures in layman's terminology to patient including required
records, pathology slides and radiology films to bring or send 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
Advanced New Patient Scheduling and Coordination 20 %
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 clncal 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
coordnated with possible clnical trials, testing, surgical procedures and care within other
departments (eg general surgery, cardiology) and with other external providers
Surgery Scheduling %2
Coordinates scheduling of all outpatient and inpatient surgeries for the surgical practice Ensures
that all surgical procedures are scheduled within a clinically appropriate time frame Interfaces
with patients, physicians and hospital staff to ensure adequate communication regarding all aspects
of surgical services
Interacts with clinical and academic staff to coordinate surgical activities with physician's other
responsblities Processes complex hospital admission forms, schedules pre-surgical tests and
appointments, and secures all necessary resources and equipment for surgery
Manages complex scheduling coordination related to securing OR time outside of designated block
time in the operating rooms Works to maximize both OR and surgical robots utilization as well as
complex joint cases with one or more additional surgeons or other services
Advanced Surgery Scheduling 15 %
Coordinates pre-operative anesthesia appointments with other testing, authorzation 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 physcian
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
Revenue Cycle 5 %
Performs cash collection and depositing functions as assigned, complying with all established
policies and procedures
Communicates Medical Center admnstrative 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
Obtains and documents insurance authorzations for establshed 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 securing authorzation
Works with patients and staff to confirm availabilty and accuracy of medical information within
APeX and to ensure compliance with all hospital policies and procedures
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 RFl 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 authorzations that often require precise documentation in
specific formats to receive approval
Provide assistance with medication authorization for new medications and refills
Advanced Revenue Cycle %
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 (eg J codes for medications hke
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 Initratives
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 vist volume, etc and creates reports in Microsoft Excel
Oversees and coaches staff on complex authorization requests as they arse
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
improve cash collection rates for the practice
Check in / Front Desk. %
Greets and welcomes patients making eye contact and utilizing AIDET standards
to
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
maintainng 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 avalability
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
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 coordnation and review, cash
deposits, DME oversight and scheduling functions 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 Provides support to all functions of the administrative teams to
include message boards, referrals, Apex in baskets, scanning and filing
Cadence Template Builder %5
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 avaid custamer service problems
Administrative and Patient Care Coordination Responsibilities 5%
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 adminstrative 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
Screens 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
clncal 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 %
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 clnical 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
Advanced Administrative and Patient Care Coordination Responsibilities 10 %
Acts as liaison with Concierge Services Expedites requested services
Coordinates complex patient care coordination activities Arranging appointments and testing,
which may or may not include Tumor block genetic testing, Home Care, Physical Therapy, starting
paperwork for durable medical equipment or disability paperwork and following up on all other
paper work, i e Workers Compensation as necessary
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 For example, patients receiving
neoadjavent chemotherapy who will be scheduled for surgery once their tumor has shrunk and
must be evaluated by the MD after cycle 3 of their chemotherapy regimen The PA IV will need to
keep track of the patient and schedule a timely appointment with the surgeon and the medical
oncologist to coordinate planning for surgery scheduling
Is skilled and able to book Radiology appointments directly into Radiology scheduling software
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 arse
Oversight with maintaining Open Access schedules in order to meet the Patient-Centered Medical
Home (PCMH) standards (could include Direct Access scheduling into the generc job template)
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
* 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
* Works applicable APeX workqueues to address patient care and service matters
o Create and send administrative communications via MyChart
0 Create SmartPhrase templates associated with administrative functions
Create and route patient letters associated with adminstrative matters
0 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
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 Joint Commission, Title22
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 %
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
Advanced General Performance %
Facltates Float coverage as needed for practice (eg when float is assigned, work with float to
ensure successful coverage of work)
Serves on and contributes documentation to the Patient Centered Medical Home application
workgroup
Environmental Responsibilities 5 %
Reports any malfunctioning of equipment.
Complies with recommendations made by ergonomic specialists to avoid workplace injury
Complies with infection control policies related (eg does not eat at the front desk or in patient
care areas)
Moderate Complex Environmental Responsibilities %
* Serves as practice deputy for life /safety activities helps lead drills
Customer Service Outreach 5 %
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 intiatives as outlined by the Medical Center leadership
through active participation and initiation
Obtains and evaluates all relevant information to handle inquiries and complaints
Strong team player, has a dedicated work ethic, and is willing to learn and adapt to new tasks when
asked 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 clinc/practice operations
Leads by example in the areas professional appearance, demeanor and body language, makng 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.
Lead role duties 10 %
Addresses and resolves escalated issues of day to day operations (e g customer service, provider
complaints, cross departmental communication or coordination problems, etc.)
Serves as a liaison to management to advise on, take lead action on, and provide direction on
process improvements initiatives
Acts as a primary resource for one or more designated functions in the department (e g, APeX
SuperUser)
Provides feedback related to staff performance
Supports staff through orientation, training and oversight Will attend monthly organization
meetings/trainings to enhance SuperUser role within the practice
Is a team player who works closely with others and who is flexible in dealing with the changing
priorities Is a seff reliant individual who synthesizes knowledge of practice operations in order to
problem-solve, prioritize and facilitate complex transactions in the course of daily activities
Living Pride Standards
Service Excellence
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
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 entre 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 flexibilty regarding the modification of tasks or workflows within
assigned duties and job functions
Perform other duties as assigned
Other clerical duties as assigned

Required Requirements

• 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 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

Preferred Qualifications

• 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.

Required Requirements

• 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 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

Preferred Qualifications

• 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.