Job Description

Payroll Title:
PAT BILL AND COLL REPR 3
Department:
HEART TRANSPLANT
Salary Range
Commensurate with Experience
Worksite:
La Jolla Medical Center
Appointment Type:
Career
Appointment Percent:
100%
Union:
Uncovered
Total Openings:
1
Work Schedule:
Days, 8 hrs/day, Monday-Friday

As a federally-funded institution, UC San Diego Health maintains a marijuana and drug free campus. New employees are subject to drug screening.

#112444 Program Referral Coordinator

Filing Deadline: Tue 11/30/2021

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 and influenza before they will be allowed on campus or in a facility or office. For more information visit: Flu Vaccine Mandate / COVID Vaccine Policy

UCSD Layoff from Career Appointment: Apply by 10/21/21 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.

Special Selection Applicants: Apply by 11/01/21. Eligible Special Selection clients should contact their Disability Counselor for assistance.

This position will remain open until filled.

DESCRIPTION

Under the direction of the Heart Transplant and LVAD Clinical Manager for the heart transplant and VAD programs, the Program Referral Coordinator is responsible for managing and processing incoming referrals from internal and external providers to the advanced heart failure and transplant programs. The Program Referral Coordinator will work directly with DBD (Director Business Development) to ensure ease of referral, referral issue resolution and, report review. Provides high-level customer service to all stakeholders inside and outside the organization. Is involved with patient, third party, government, and physician billing and / or collections activities. Provides for coordinated processes, procedures and systems, customer service delivery models and ensuring compliance with internal policy and external agency regulations.

Investigates highly complex contracts or DOFR's, evaluate alternative funding sources for patients in need, and propose procedures and systems in support of efficient workflows and maximization of reimbursement

KEY RESPONSIBILITIES: - Performs detailed financial screening of benefits. Informs patients and clinical team of anticipated gaps in coverage. - Researches complex billing issues; confirms primary and secondary payers, closely evaluates coordination of benefits; identifies appropriate contract / plan to provide payment for all phases of care. - Trains staff on changes to systems or procedures.- Serves as a resource for billers and collectors; resolves systems, procedural and policy issues in the course of daily operations. - Distributes written materials to educate patients about the referral process.- Tracks progress of work, producing metrics and dashboards; analyzes trends and recommends functional modifications to increase efficiencies.- Collaborates with multidisciplinary team across the Center for Transplant as needed.
- Responsibilities include all aspects of referral intake via phone, email, and fax.- Requests that new referring providers are correctly added to EPIC EMR.- Manages referral in Phoenix database, ensures referring provider added to patient record accurately.- Partners with transplant financial coordinators, ensuring accurate assessment of transplant benefits.
- Obtains authorizations as needed. - Maintains the referral workflow and actively contributes to the weekly referral- tracking meeting. Communicates accurate up-to-date timelines and follows proper escalation process for any delays. - Maintains Outlook contacts for inside and outside referring offices. Sends correspondence to the referring provider, as directed by the Director of Business Development and Clinical Manager.

MINIMUM QUALIFICATIONS:

  • Seven (7) years of related administrative experience, education/training, OR a Bachelor’s degree in related area plus three (3) years of related experience/training.

  • Excellent communication skills both verbally and in writing. Ability to initiate and manage projects effectively, using a positive, flexible, consultative and, supportive approach.

  • Ability to manage diverse projects through effective priority setting. Proficient with computers and applications such as MS Office (Word, Excel, Outlook, PowerPoint).

  • In depth knowledge of EPIC and EPIC Phoenix, and other systems as required.

PREFERRED QUALIFICATIONS

  • Previous experience in a large healthcare environment.
  • Bilingual - English/Spanish.
  • Experience working on a multidisciplinary team.

SPECIAL CONDITIONS

  • 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!

Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.

UC San Diego Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity or sexual orientation. For the complete University of California nondiscrimination and affirmative action policy see: http://www-hr.ucsd.edu/saa/nondiscr.html

UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.

Application Instructions

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