- High school diploma or GED required.
- Three (3) years of clerical experience, including two (2) years at the Admitting Worker or comparable level.
- Proficiency in health insurance eligibility and authorization requirements.
- Knowledge of government program regulations, Medi-Cal, CCS, and third-party payors' patient liability determination
- Admissions, Discharges & Transfer experience
- Ability to problem solve; ability to analyze data and recommend changes.
- Demonstrated ability to utilize, understand, and adapt to the use of electronic health record systems, billing systems, etc.
- Attention to detail: Understand cause and effect when accounts are not processed appropriately
- Excellent customer service skills to interact with medical providers, clinic and department staff and CCS county offices.
- Ability to work collaboratively with a culturally diverse staff and patient/family population.
- Ability to work independently with minimum supervision.
- Knowledge of office machines; typing 30 wpm to include Personal Computer skills.
- Knowledge of Medical Terminology.
- Excellent verbal and written communication skills.
- Ability to write clearly and concisely in the English language.
- Willing to work flexible hours that include weekends, overtime, and other shifts as assigned.
- Ability to work on-site at our Emeryville office location.
Authorization Representative – California Children's Services - SanFrancisco, United States - University of California, San Francisco
Description
Pediatric California Children's Services Support
Full Time
75248BR
Job Summary
The California Children's Services (CCS) Authorization Representative is individually accountable for securing treatment authorizations for the CCS patient population including inpatient admissions and ancillary outpatient services. The CCS Unit is responsible for meeting organizational financial targets of approximately $22 million each week for CCS DNB (Discharged Not Billed) patient accounts. Collectively, the CCS Authorization Representative team contributes to timely and appropriate patient access and service for CCS-covered conditions. The scope of work that the Authorization Representative is responsible for requires ongoing account analysis, consistent communication of technical medical language and unique patient accounts, and CCS coverage guidelines and billing knowledge.
The primary responsibility of the CCS Authorization Representative is to communicate patient services authorization requests with all CCS service area counties, for the approximate 58 counties throughout the State of California, and requesting authorizations by submitting Service Authorization Request (SAR) forms. The CCS Authorization Representative works closely with case managers and ordering providers' office staff and external clinical professionals. On occasion and in conjunction with the unit supervisor, may interact with State Medical Directors to resolve individual account authorization or coverage issues. In general, the CCS Authorization Representative is responsible for all aspects of financially securing CCS insurance and authorization data for patient services. The CCS Authorization Representative's responsibilities include, though are not limited to: 1) verifying demographic and clinical information relevant to the patient's visit 2) verifying insurance eligibility and benefits, 3) securing authorizations, and 4) properly notating all activity in UCSF's APeX electronic health record system.
The final salary and offer components are subject to additional approvals based on UC policy. To see the salary range for this position (we recommend that you make a note of the job code and use that to look up):TCS Non-Academic Titles Search )
Please note: The compensation ranges listed online for roles not covered by a bargaining unit agreement are very wide, however, a job offer will typically fall in the range of 80% – 120% of the established mid-point. An offer will take into consideration the experience of the final candidate AND the current salary level of individuals working at UCSF in a similar role.
For roles covered by a bargaining unit agreement, there will be specific rules about where a new hire would be placed on the range.
To learn more about the benefits of working at UCSF, including total compensation, please visit:
Required Qualifications
Preferred Qualifications
Bilingual capability a plus
About UCSF
At UCSF Health, our mission of innovative patient care, advanced technology and pioneering research is redefining what's possible for the patients we serve – a promise we share with the professionals who make up our team.
Consistently ranked among the top 10 hospitals nationwide by U.S. News & World Report – UCSF Health is committed to providing the most rewarding work experience while delivering the best care available anywhere. In an environment that allows for continuous learning and opportunities for professional growth, UCSF Health offers the ideal atmosphere in which to best use your skills and talents.
Pride Values
UCSF 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.
In addition to our PRIDE values, UCSF is committed to equity – both in how we deliver care as well as our workforce. We are committed to building a broadly diverse community, nurturing a culture that is welcoming and supportive, and engaging diverse ideas for the provision of culturally competent education, discovery, and patient care. Additional information about UCSF is available at
Join us to find a rewarding career contributing to improving healthcare worldwide.
Equal Employment Opportunity
The 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.
Job Code and Payroll Title
009031 ADMITTING WORKER PRN
Job Category
Accounting / Finance, Administrative Support, Financial, Support Services
Bargaining Unit
American Federation of State, County and Municipal Employees – Patient Care Technical Unit (AFSCME-EX)
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