University of California - San Francisco is looking for Patient Care Coordinator 3 in San Francisco, CA. This local job opportunity with ID 3736959021 is live since 2026-07-02 01:17:19.

The Patient Care Coordinator is primarily responsible for representing the administrative team as the public face of the Practice and works closely with the administrative, clinical and management teams to support practice operations and customer service recovery and intervention efforts. S/he provides support to all functions of the administrative teams including but not limited to: Liaison for Cancer Center and Rad Onc, new patient coordination, telephone encounters, referrals, APeX in-baskets, scanning, filing, authorizations, and billing. The Patient Care Coordinator is responsible for the maintenance of all routine clerical operations and communications. S/he adheres to the UCSF House and Telephone Standards and is sensitive to the needs of patients, staff and providers at all times. The Patient Care Coordinator is a team player who works closely with others and who is flexible in dealing with the changing priorities. S/he is a self-reliant individual who synthesizes his/her knowledge of practice operations in order to problem-solve, prioritize and facilitate complex transactions in the course of his/her daily activities.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.
Advanced New Patient Scheduling and Coordination 25 %

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 clinical 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 coordinated with possible clinical trials, testing, surgical procedures and care within other departments (e.g. general surgery, cardiology) and with other external providers.

On a daily basis reviews and works referral work queues documenting activities within the referral record. Acts as the primary contact for referring physicians and new patientsIf 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.Coordinate E-Consults for Physician to Physician consultation web site for 12 Neurosurgeons by registration, gathering medical documentation and imaging uploaded to APEX for physician review for peer to peer. 24 hour turn around Manage 300-400 new patient E-Fax's daily. Immediate processing for all urgent referrals and within 24-48 hours for non-urgent. Facilitate Film Reviews for second opinion for patients unable to travel or have office consultations due insurance issues or residing out of state.Assign new patients to providers as required, taking into account scheduling issues.

Schedules and registers patients by telephone or in person before first appointment meeting established accuracy and performance standards. Completes appropriate practice intake paperwork and follows established 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 Revenue Cycle 3%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 (e.g. J codes for medications like 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. Initiatives 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, visit volume, etc. and creates reports in Microsoft Excel.Oversees and coaches staff on complex authorization requests as they arise. 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 announcementsAs practice SuperUser will produce reports and review with staff cash collection barriers to improve cash collection rates for the practice. Revenue Cycle 5%Performs cash collection and depositing functions as assigned, complying with all established policies and procedures.Communicates Medical Center administrative 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 authorizations for established patient visits, referrals and procedures or ancillary services. Communicates clinical information from medical records authorization requests to insurance companies. Complex Insurance eligibility and benefits verified in detail in referral notes to expedite for Demonstrates competency working with CPT codes, ICD-9, and ICD-10 for the purpose of scheduling and securing authorization.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 procedures, specialty visits and ancillary testing and coordinates with Hospital Admissions Department as needed.Verification of insurance eligibility and benefits for patients to be scheduled in an urgent manner. Work with UCSF Contracting and Finance team to problem solve and keep up with insurance policy changes impacting patient care coordinationTriage all new referrals for workman's compensation, out of state and/or out of network coverages, obtaining COBs and MSPs, and ensuring authorization appointments regarding consultation, diagnostic imaging, procedures and/ or surgeries for all referrals. Moderate Complex Revenue Cycle 10 %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 . click apply for full job details