Patient Care Authorization Specialist
2 weeks ago
Overview:
At the University of California, San Francisco, we are dedicated to improving the health and well-being of individuals through our commitment to patient care, research, and education.
Mission:
Our success hinges on fostering a culture of collaboration, excellence, leadership, and respect. We seek individuals who embody the values of professionalism, integrity, diversity, and excellence that are essential to our mission.
Role Summary:
The Patient Care Authorization Specialist plays a crucial role in obtaining financial clearance for patients, providers, and the healthcare system. This position requires close collaboration with administrative, clinical, and management teams to enhance practice operations and customer service recovery efforts.
Key Responsibilities:
- Facilitate financial clearance functions, including authorizations, PAFRs, LOAs billing, and RFIs.
- Work independently under the guidance of the Revenue Manager and/or supervisor to address billing-related issues in APeX (Epic), aiming to optimize payor reimbursement and RVU charge capture.
- Possess a foundational understanding of healthcare terminology, processes, and workflows, along with healthcare billing and authorizations to effectively resolve account issues.
Daily Tasks:
- Conduct thorough reviews of medical record documentation to address billing and authorization inquiries.
- Manage assigned authorization and billing work queues (WQs) daily to minimize denials.
- Prioritize multiple tasks while collaborating effectively with all levels of staff, including faculty, management, and colleagues both within and outside the unit.
Additional Duties:
- Maintain routine clerical operations and communications.
- Adhere to established standards and remain sensitive to the needs of patients, staff, and providers at all times.
- Exhibit flexibility in adapting to changing priorities and demonstrate a self-reliant approach to problem-solving.
Impact:
This position significantly contributes to patient care in an outpatient setting by delivering exceptional customer service and ensuring accurate information flow between medical staff, departments, and insurance companies, thereby maximizing unit efficiency.
Work Environment:
The Patient Care Authorization Specialist may be required to work at various UCSF campuses as needed.
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