University of California - San Francisco Campus and Health
Patient Financial Clearance Specialist
University of California - San Francisco Campus and Health, San Francisco, California, United States, 94199
Patient Financial Clearance SpecialistDepartment:
Pathology
Employment Type:
Full Time
Job Code:
79333BR
Job SummaryThe Patient Financial Clearance Specialist (PC3) is a key member of the Division of Dermatopathology's revenue cycle team. The individual is primarily responsible for securing financial clearance for clinical laboratory patients and referring healthcare organizations. The PC3 works closely with the lab's accessioning team to verify patient insurance eligibility and coverage for each case, communicates with insurance providers to obtain required authorizations or referrals, and documents essential billing information in the laboratory information management system.
Under the general direction of the revenue cycle supervisor, the PC3 works independently to resolve payment issues with commercial and government sources that provide healthcare coverage through numerous types of health plans. The incumbent must acquire an advanced understanding of payer requirements for the lab's top payers, which include Medicare, Blue Cross, Aetna, Cigna, United Healthcare, Tricare, and Medicaid.
The PC3 is responsible for working a daily caseload of assigned insurance and authorization work queues. The PC3 works with the lab's billing agent to rapidly fulfill requests for additional information (RAIs) for claims that cannot be filed. The PC3 acts quickly to resolve payer denial errors and takes corrective actions to reduce the occurrence of denials for preventable reasons such as incorrect demographic or plan information or no prior authorization.
The PC3 responds to incoming billing inquiries from patients, referring medical practices, other diagnostic labs, health plan providers, and the lab's billing and collections agencies. The PC3 also works with the lab's clinical teams and physician providers to support practice operations and customer service activities. Additionally, the PC3 is responsible for the maintenance of all revenue cycle clerical tasks such as data entry or scanning, and for routine communications.
The PC3 has a can-do attitude and a positive mindset. The successful incumbent is a motivated, self-reliant individual who works efficiently and understands the collective goal of the revenue cycle group. The PC3 must have the ability to analyze and prioritize medical billing issues and to effectively communicate with a wide variety of individuals, including patients, providers, and other clinicians.
Department DescriptionThe Department of Pathology at UCSF aims to achieve the highest standards in patient care, research, and education. The Department provides diagnostic pathology services in a wide variety of subspecialties with highly trained subspecialists who are recognized nationally and internationally for their expertise.
Required Qualifications
High school graduate or equivalent with four years of work experience; or bachelor's degree with six months of work experience; or equivalent combination of education and experience.
Strong computer skills including intermediate proficiency with Microsoft Excel and Word.
Ability to sit at a computer terminal with telephone headphones for extended periods of time.
Ability to navigate through insurance verification and health plan portals, and POS payment systems.
Ability to prioritize case workload, solve billing problems, and meet service time standards.
Possess excellent communication skills including listening, observing, speaking, and writing.
Provide courteous service to all stakeholders including patients, providers, and other clinicians.
Ability to complete assigned caseload efficiently and solve problems with minimal supervision.
Reliable, consistent work attendance and punctuality.
Preferred Qualifications
Work experience at a University of California academic health center.
Work experience in a dermatology medical practice or pathology clinical lab.
Work experience in a medical billing environment or with a healthcare industry payer.
Knowledge of medical terminology and professional fee coding.
Advanced understanding of payer requirements for Medicare, Medicaid, and HMOs/PPOs.
Familiarity with the Health Insurance Portability and Accountability Act (HIPAA).
About UCSFThe University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.
Pride ValuesUCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity, and excellence - also known as our PRIDE values.
Equal Employment OpportunityThe University of California San Francisco is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
OrganizationCampus
Job Code and Payroll Title004818 PRACTICE CRD 3
Job CategoryAdministrative Support, Support Services
Bargaining UnitTeamsters Local 2010 - Clerical and Allied Services Unit (CX)
Employee ClassCareer
Percentage100%
LocationMount Zion (SF)
ShiftDays
Shift Length8 Hours
Additional Shift DetailsMonday-Friday 8am-5pm
#J-18808-Ljbffr
Pathology
Employment Type:
Full Time
Job Code:
79333BR
Job SummaryThe Patient Financial Clearance Specialist (PC3) is a key member of the Division of Dermatopathology's revenue cycle team. The individual is primarily responsible for securing financial clearance for clinical laboratory patients and referring healthcare organizations. The PC3 works closely with the lab's accessioning team to verify patient insurance eligibility and coverage for each case, communicates with insurance providers to obtain required authorizations or referrals, and documents essential billing information in the laboratory information management system.
Under the general direction of the revenue cycle supervisor, the PC3 works independently to resolve payment issues with commercial and government sources that provide healthcare coverage through numerous types of health plans. The incumbent must acquire an advanced understanding of payer requirements for the lab's top payers, which include Medicare, Blue Cross, Aetna, Cigna, United Healthcare, Tricare, and Medicaid.
The PC3 is responsible for working a daily caseload of assigned insurance and authorization work queues. The PC3 works with the lab's billing agent to rapidly fulfill requests for additional information (RAIs) for claims that cannot be filed. The PC3 acts quickly to resolve payer denial errors and takes corrective actions to reduce the occurrence of denials for preventable reasons such as incorrect demographic or plan information or no prior authorization.
The PC3 responds to incoming billing inquiries from patients, referring medical practices, other diagnostic labs, health plan providers, and the lab's billing and collections agencies. The PC3 also works with the lab's clinical teams and physician providers to support practice operations and customer service activities. Additionally, the PC3 is responsible for the maintenance of all revenue cycle clerical tasks such as data entry or scanning, and for routine communications.
The PC3 has a can-do attitude and a positive mindset. The successful incumbent is a motivated, self-reliant individual who works efficiently and understands the collective goal of the revenue cycle group. The PC3 must have the ability to analyze and prioritize medical billing issues and to effectively communicate with a wide variety of individuals, including patients, providers, and other clinicians.
Department DescriptionThe Department of Pathology at UCSF aims to achieve the highest standards in patient care, research, and education. The Department provides diagnostic pathology services in a wide variety of subspecialties with highly trained subspecialists who are recognized nationally and internationally for their expertise.
Required Qualifications
High school graduate or equivalent with four years of work experience; or bachelor's degree with six months of work experience; or equivalent combination of education and experience.
Strong computer skills including intermediate proficiency with Microsoft Excel and Word.
Ability to sit at a computer terminal with telephone headphones for extended periods of time.
Ability to navigate through insurance verification and health plan portals, and POS payment systems.
Ability to prioritize case workload, solve billing problems, and meet service time standards.
Possess excellent communication skills including listening, observing, speaking, and writing.
Provide courteous service to all stakeholders including patients, providers, and other clinicians.
Ability to complete assigned caseload efficiently and solve problems with minimal supervision.
Reliable, consistent work attendance and punctuality.
Preferred Qualifications
Work experience at a University of California academic health center.
Work experience in a dermatology medical practice or pathology clinical lab.
Work experience in a medical billing environment or with a healthcare industry payer.
Knowledge of medical terminology and professional fee coding.
Advanced understanding of payer requirements for Medicare, Medicaid, and HMOs/PPOs.
Familiarity with the Health Insurance Portability and Accountability Act (HIPAA).
About UCSFThe University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.
Pride ValuesUCSF is a diverse community made of people with many skills and talents. We seek candidates whose work experience or community service has prepared them to contribute to our commitment to professionalism, respect, integrity, diversity, and excellence - also known as our PRIDE values.
Equal Employment OpportunityThe University of California San Francisco is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
OrganizationCampus
Job Code and Payroll Title004818 PRACTICE CRD 3
Job CategoryAdministrative Support, Support Services
Bargaining UnitTeamsters Local 2010 - Clerical and Allied Services Unit (CX)
Employee ClassCareer
Percentage100%
LocationMount Zion (SF)
ShiftDays
Shift Length8 Hours
Additional Shift DetailsMonday-Friday 8am-5pm
#J-18808-Ljbffr