Patient Financial Clearance Specialist
Company: University of California - San Francisco
Location: San Francisco
Posted on: September 23, 2024
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Job Description:
Patient Financial Clearance Specialist
Pathology
Full Time
79333BR
Job Summary
The 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. The
individual ensures that accurate and complete medical billing
information for each case is promptly submitted to the lab's
medical billing agent.
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. These plans include traditional
indemnity or fee-for-service (FFS) plans, and managed care plans
like health maintenance organizations (HMO), preferred provider
organizations (PPO), and point-of-service (POS) 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 is a team player who works well with
the other revenue cycle staff and with the Division's
administrative staff, eg finance or marketing. The PC3 must have
the ability to analyze and prioritize medical billing issues and to
effectively communicate a wide variety of individuals, including
patients, providers, and other clinicians.
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 (ucop.edu)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:
https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html
Department Description
The 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. The
Department's research programs are diverse and interface with a
wealth of basic and translational research programs that are a
hallmark of UCSF. Our educational programs include a
research-intensive academic residency program and fellowships in
cytopathology, dermatopathology, gastrointestinal and liver
pathology, gynecologic pathology, neuropathology and surgical
pathology.
The faculty of the Division of Dermatopathology and Oral Pathology
are internationally recognized for delivering expert analysis and
interpretation of skin disease for referring physicians. Each
specimen that passes through the clinical lab is issued a diagnosis
by one of the Division's faculty physicians. The Division processes
approximately 180,000 cases per year and is responsible for the
billing and collection of payments from hundreds of different
third-party payers and organizational clients.
Required Qualifications
Preferred Qualifications
About UCSF
The 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. It is the
only campus in the 10-campus UC system dedicated exclusively to the
health sciences. We bring together the world's leading experts in
nearly every area of health. We are home to five Nobel laureates
who have advanced the understanding of cancer, neurodegenerative
diseases, aging and stem cells.
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
diversity.ucsf.edu
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.
Organization
Campus
Job Code and Payroll Title
004818 PRACTICE CRD 3
Job Category
Administrative Support, Support Services
Bargaining Unit
Teamsters Local 2010 - Clerical and Allied Services Unit (CX)
Employee Class
Career
Percentage
100%
Location
Mount Zion (SF)
Shift
Days
Shift Length
8 Hours
Additional Shift Details
Monday-Friday 8am-5pm
Keywords: University of California - San Francisco, San Francisco , Patient Financial Clearance Specialist, Accounting, Auditing , San Francisco, California
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