Patient Service Representative 3

About the role

The incumbent is responsible for sustaining an environment of intrinsic goodwill for the practice while providing optimum services to patients. This position performs a variety of duties, providing front office support for the department/clinical team for which it is assigned.

Responsibilities

• Coordination of Medical Office Services (50%)
• Additional Job Functions (50%)

Requirements

• High School / GED equivalent or related work experience
• Experience with practices and protocols related to medical office and/or health care scheduling or insurance procedures
• Ability to accomplish a variety of concurrent assignments in an effective and efficient manner
• Problem solving skills to independently define a problem, identify the resources available to help solve the problem, create viable solutions, and take the necessary action to implement problem resolution and ensure prompt and satisfactory resolution
• Decision making skills to independently exercise delegated authority to take action and to appropriately seek assistance from others when limits of delegated authority have been reached
• Interpersonal skills to establish and maintain effective working relationships with all co-workers; to consistently interact with patients and other members of the public with patience, courtesy and professionalism, both in person and on the telephone; and to effectively respond to individuals who may be angry or upset
• Ability to efficiently use computer system applications for all functions required for this position, including electronic mail, spreadsheets, word processing, and medical office management
• Writing skills, using proper English grammar, spelling and punctuation, sufficient to compose messages and/or routine correspondence, which is clear, concise and easy to understand
• Bookkeeping skills sufficient to maintain accurate records of patient financial transactions, prepare related financial reports, balance cash box, and prepare deposits
• Organizing skills to establish priorities for own work within stated guidelines; respond flexibly to changes in priorities; and maintain work effectiveness in a setting with a high volume of patient activity and frequent interruptions
• Filing skills to maintain logs and files of information in alphabetical, chronological and/or numerical order, such that it is current and easily retrievable
• In depth knowledge of health care insurance systems, which may include Medi-Cal, MediCare, HMO, PPO, fee-for-service, county funded coverage, and worker’s compensation, sufficient to properly obtain and track authorizations, appoint patients, make referrals for consults, diagnostics and ancillary services, coordinate hospital services, complete and submit billing documentation, and explain provisions and requirements to patients
• Knowledge of ICD-10, CPT and HCPCS coding guidelines sufficient to accurately identify services performed, including diagnoses, procedures, and supplies
• Knowledge and experience of practices and protocols related to medical office procedures, (i.e. medical terminology, appointments, medical records, insurance verification, cashiering, billing, etc.)

Qualifications

• High School / GED equivalent or related work experience
• Experience with practices and protocols related to medical office and/or health care scheduling or insurance procedures
• Ability to accomplish a variety of concurrent assignments in an effective and efficient manner
• Problem solving skills to independently define a problem, identify the resources available to help solve the problem, create viable solutions, and take the necessary action to implement problem resolution and ensure prompt and satisfactory resolution
• Decision making skills to independently exercise delegated authority to take action and to appropriately seek assistance from others when limits of delegated authority have been reached
• Interpersonal skills to establish and maintain effective working relationships with all co-workers; to consistently interact with patients and other members of the public with patience, courtesy and professionalism, both in person and on the telephone; and to effectively respond to individuals who may be angry or upset
• Ability to efficiently use computer system applications for all functions required for this position, including electronic mail, spreadsheets, word processing, and medical office management
• Writing skills, using proper English grammar, spelling and punctuation, sufficient to compose messages and/or routine correspondence, which is clear, concise and easy to understand
• Bookkeeping skills sufficient to maintain accurate records of patient financial transactions, prepare related financial reports, balance cash box, and prepare deposits
• Organizing skills to establish priorities for own work within stated guidelines; respond flexibly to changes in priorities; and maintain work effectiveness in a setting with a high volume of patient activity and frequent interruptions
• Filing skills to maintain logs and files of information in alphabetical, chronological and/or numerical order, such that it is current and easily retrievable
• In depth knowledge of health care insurance systems, which may include Medi-Cal, MediCare, HMO, PPO, fee-for-service, county funded coverage, and worker’s compensation, sufficient to properly obtain and track authorizations, appoint patients, make referrals for consults, diagnostics and ancillary services, coordinate hospital services, complete and submit billing documentation, and explain provisions and requirements to patients
• Knowledge of ICD-10, CPT and HCPCS coding guidelines sufficient to accurately identify services performed, including diagnoses, procedures, and supplies
• Knowledge and experience of practices and protocols related to medical office procedures, (i.e. medical terminology, appointments, medical records, insurance verification, cashiering, billing, etc.)

Skills

• Customer service experience and/or call center experience
• Recent experience with EMR, such as EPIC, including In Basket and Work Queues
• Training or equivalent recent experience in billing, authorizations, referrals, medical terminology, and comprehensive insurance plans and products
• Recent experience in outpatient medical office
• Experience working in a front office for a clinic, physician or health insurance company processing referrals or authorizations for patient services
• Previous experience in the specialty of the hiring outpatient clinic
• Demonstrated knowledge of Health System and UCD policies and procedures, or ability to learn
• Comprehension of University requisition systems, including those needed for ordering supplies and medical records

Benefits

• High quality and low-cost medical plans to choose from to fit your family's needs
• UC pays for Dental and Vision insurance premiums for you and your family
• Extensive leave benefits including Pregnancy and Parental Leave, Family & Medical Leave
• Paid Holidays annually as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement
• Paid Time Off/Vacation/Sick Time as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement
• Continuing Education (CE) allowance and Education Reimbursement Program as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement
• Access to free professional development courses and learning opportunities for personal and professional growth
• WorkLife and Wellness programs and resources
• On-site Employee Assistance Program including access to free mental health services
• Supplemental insurance offered including additional life, short/long term disability, pet insurance and legal coverage
• Public Service Loan Forgiveness (PSFL) Qualified Employer & Student Loan Repayment Assistance Program for qualified roles
• Retirement benefit options for eligible roles including Pension and other Retirement Saving Plans. More information on our retirement benefits can be found here

Physical Demands

• Standing - Occasional Up to 3 Hours
• Walking - Occasional Up to 3 Hours
• Sitting - Frequent 3 to 6 Hours
• Lifting/Carrying 0-25 Lbs - Occasional Up to 3 Hours
• Pushing/Pulling 0-25 Lbs - Occasional Up to 3 Hours
• Bending/Stooping - Occasional Up to 3 Hours
• Squatting/Kneeling - Occasional Up to 3 Hours
• Twisting - Occasional Up to 3 Hours
• Reaching overhead - Occasional Up to 3 Hours
• Keyboard use/repetitive motion - Frequent 3 to 6 Hours

Mental Demands

• Sustained attention and concentration - Frequent 3 to 6 Hours
• Complex problem solving/reasoning - Occasional Up to 3 Hours
• Ability to organize & prioritize - Frequent 3 to 6 Hours
• Communication skills - Frequent 3 to 6 Hours
• Numerical skills - Occasional Up to 3 Hours
• Constant Interaction - Frequent 3 to 6 Hours
• Customer/Patient Contact - Frequent 3 to 6 Hours
• Multiple Concurrent Tasks - Frequent 3 to 6 Hours

Work Environment

• Smoke and tobacco free campus effective January 1, 2014
• Must be willing to work overtime, variable days (including weekends), hours, and locations as required to meet business needs of the practice

Special Requirements

• This is a critical position, as defined by UC Policy and local procedures, and as such, employment is contingent upon clearing a criminal background check(s) and may include drug screening, medical evaluation clearance and functional capacity assessment
• The duties or functions of this position include the handling of cash (or cash equivalents)
• This position is designated as a mandated reporter under CANRA and UC policy, and employment is contingent on compliance with applicable policies, procedures and training requirements