110919 - Patient Access Manager
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#110919 Patient Access ManagerInitial Review Date: Thu 9/16/2021
For the safety and well-being of the entire university community, the University of California requires, with few exceptions, that all students, faculty and staff be vaccinated against the COVID-19 virus before they will be allowed on campus or in a facility or office. For more information visit: https://ucnet.universityofcalifornia.edu/news/2021/07/ucs-covid-19-vaccine-policy.html
UCSD Layoff from Career Appointment: Apply by 08/20/21 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 08/31/21. Eligible Special Selection clients should contact their Disability Counselor for assistance.
This position will remain open until filled.
Includes but not limited to the management and administration of prior authorizations, patient pre-registration and registration, admissions, transfers, and verification of insurance eligibility. Functions are performed in concert with clinical and business departments across the organization, to ensure efficient patient flow and to maximize revenue collections.
Works closely with multiple department to maintain payer requirements and analyze denials. Participates in strategic planning and budget processes. Provides direction, sets priorities and analyzes workflow for authorization team, according to established policies and management guidance. Recommends, develops and implements new and revised procedures as needed.
Provides oversight to ensure contract and benefit eligibility, prior authorization, insurance verification, and post service requests are completed accurately. Ensures urgent authorization requests are handled in a timely and compliant manner. Ensure compliance with government and commercial billing processes.
As needed, works in conjunction with other departments to improve service quality initiatives, develop audit tools, and meet regulatory and other quality standards.
Manages Patient Access related DNB, claim edits and stop bills, as needed. Track, trend, and report on Patient Access related CFB, as needed. Recommends, reviews, and oversees the implementation of best practice methods and policies which improve both patient quality of care and the financial outcomes. Utilizes strong management practices to create a culture of teamwork, collaboration, and timely achievement of objectives and goals. Responsible for employee performance reviews, recruitment, retention, terminations, and staff development and training programs.
Nine (9) years of related experience, education/training in Revenue Cycle Management, Patient Access, Authorization, Case Management/Utilization Review, OR a Bachelor’s degree in related area plus five (5) years of related experience/training in Revenue Cycle Management, Patient Access, Authorization, Case Management/Utilization Review.
Experience and proven success in supervisory, organizational, and customer service skills to effectively supervise and prioritize the activities of subordinate staff, and to manage the complex workflow and multiple priorities of admissions and registration.
Proficiency with EPIC applications.
Knowledge of Prior Authorization processes.
Government (Medi-Cal, Medicare, CCS) billing requirements.
Denials management experience.
Must be able to work various hours and locations based on business needs.
Employment is subject to a criminal background check and pre-employment physical.
Job offer is contingent on successful engagement in the UC COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).
UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, and several outpatient clinics. UC San Diego Medical Center in Hillcrest is a designated Level I Trauma Center and has the only Burn Center in the county. We invite you to join our dynamic team!
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