Patient Access Center (PAC) Coordinator (Per Diem)

The Patient Access Center (PAC) is hiring per diem staff to assist in coverage for all teams: call center representative, referral and authorization coordinator, patient services coordinator (visit prep) and clinic front desk. Please see key responsibilities for full role duties for each post. This position may be assigned to work remotely and at various UCR Health clinic locations. This position may be required to work different shifts, including evenings, weekends, and holidays. The salary range for Patient Access Center (PAC) is $25.38 - $35.97 per hour. However, the expected pay scale for this position is $30.13 per hour. We base salary offers on a variety of considerations, such as education, licensure and certifications, experience, and other business and organizational needs. Applicants must have current work authorization when accepting a UCR staff position. Currently, we are unable to sponsor or take over sponsorship of an employment Visa for staff. As a University employee, you will be required to comply with all applicable University policies and/or collective bargaining agreements, as may be amended from time to time. Federal, state, or local government directives may impose additional requirements. \n \nPatient Services Coordinator Benefits & Eligibility Verification: Verifies insurance coverage and obtains insurance authorization for appointment and care plan. Ensures and/or secures proper insurance authorization on file prior to the patient's scheduled visit. Reviews and maintains patient accounts, secures financial arrangements on self-pay & outstanding balances prior to patient appointments, verifies and pre-registers patients and responds to patient inquiries regarding billing and insurance. Contact patients with self-pay or outstanding balances to ensure appropriate financial arrangements. Ensure patients are properly registered in the EMR according to workflows. Chart Preparation: Reviewing the last visit notes, attempting to capture any outstanding orders from the provider to the patient before their next visit, identify preventative care needs, retrieve & capture other ancillary results such as lab, x-ray, consultation notes. Prepare specific visit materials such as medications, logs, i.e. recordings of blood pressure, insulin. If patient has been hospitalized since last visit, secure hospital records to add to patient chart. Educate patients to prepare for their visit by reminding them of their financial obligations, confirm any prior outstanding orders have been completed, assign/remind them of completing questionnaires, bring medications on next visit, bringing insurance card & ID. Policies and Procedures(P&P): Protects patients' rights by maintaining confidentiality of personal and financial information. Maintains operations by following P&P; reporting needed changes. Protects patient confidentiality by making sure protected health information (PHI) is secured by not leaving PHI in plain sight and logging off the computer before leaving it unattended. Maintains knowledge and adheres to P&P for all UCR Health operations and specific billing and insurance regulations such as the No Surprise Billing Act.Referrals and Authorization Coordinator role: Request authorizations from the payer via their designated process, which may include phone, fax, and/or web portals for office visits, procedures and medications, scheduling appointments within and outside of UCR Health. Verify eligibility and insurance benefits for requested procedures and medications (including prior authorizations for medications), confirming and obtaining appropriate authorization for office visits and procedures, informing patients of their financial responsibility before their appointment, and sending out confirmation letters with appropriate preparation instructions. Process referrals for Medi-Cal, Medicare, Managed Care, County, private insurers, and self-pay. Task patient referrals at time of patient discharge via the electronic medical record (EMR) system. Request authorization/referral authorizations from insurance plans including Medi-Cal Manage Care. Adhering to the established criteria and timeframes for processing urgent authorization or referral requests. Coordinate referrals from physicians & health care facilities for patients; provide a significant level of patient education related to facilitating the administrative tasks for their illness and planned treatment; and provide a high level of analytical services over the telephone. These services include, but are not limited to: patient to physician communication, physician-to-physician communication, serve as a resource and contact for information and services, referral source to UCR Health and utilization of our EMR system to communicate patient care appointments effectively and efficiently. Obtain patients' labs and other tests results as needed for referral process. Request authorization/referral authorizations from insurance plans including Medi-Cal Manage Care. Once referral is approved, notify patient of approval/denial, and instruct patient on next steps for appointment scheduling.Call Center: Schedule new patient and follow up appointments and in office procedures. Schedule appointments for patients, based on provider availability. Reschedules patient appointments at the request of the patient and/or provider, works the reschedule queue/reschedules no show patients. Daily appointment reminder calls and calls to patients that have not shown their appointments. Perform all preregistration duties for new patients prior to making an appointment, including entering all demographics, verify and enter insurance information and inform patients of any charges or fees due and based on the type of insurance. Provide clear and courteous instructions to the caller on where the appointment was scheduled and what documents to bring to the appointment. Verify insurance coverage and eligibility and obtain insurance authorization for appointment and care plan. Reviews and maintains patient accounts, secures financial arrangements on self-pay balances prior to and during patient appointments, verifies and pre-registers patients. Greet incoming callers in a friendly and courteous manner, interact politely and helpful when assisting and providing required information to callers. Answers a high volume of clinic multi-line line and assist callers, takes messages for clinic/complaints. Send and route in-basket messages in a timely fashion. Assist patients with access and navigation to the patient portal. Outbound calls to address quality measures, new patient assignments, and wellness visits. Optimizes patients' satisfaction, provider time, and treatment room utilization by scheduling appointments in person or by telephone to fill all available provider slots. Assist with reminder calls.Special Projects / Travel May participate in projects to enhance the clinic operations, patient experience, or compliance with regulatory agencies. Provide administrative support to medical providers and medical staff. As assigned, facilitates letter of agreements with payors and contracting team. May be required to travel to other UCR Health clinic locations and UC Riverside campus offices.Electronic Medical Record (EMR) Maintains patient accounts by obtaining, recording, and updating personal, financial, and compliance information into the Electronic Medical Record (EMR). Assists providers and patients with access and navigation to the patient portal. Communication: Monitor and respond to messages in the EMR in-baskets and pools. Assist patients with MyChart sign up.\n \nMust demonstrate customer service skills appropriate to the job. Ability to recognize and handle customer complaints. Ability to accurately handle a high volume of work in a fast-paced environment with compassion, patience and positive attitude.Knowledge of pertinent laws, regulations, and guidelines governing medical records, confidentiality, privacy and provisions to others, including HIPAA.Knowledge of ICD-9/ICD-10, CPT, and HCPCS coding sufficient to identify services performed; including diagnoses, procedures, and supplies.Excellent customer service and strong interpersonal skills.Must possess the ability to multi-task between identifying areas for improving patient relations, ensuring that quality standards are met while providing extensive personalized customer service, and executing patient and operational activities.Knowledge of practices and protocols related to medical office procedures (i.e., medical terminology, appointments, medical records, insurance verification, cashiering, billing, etc.)Strong oral and written communication skills to effectively communicate with patients of varying ages, diagnosis, and multicultural backgrounds.Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties.Must demonstrate customer / patient service skills appropriate to the job.Ability to maintain a work pace appropriate to the workload and ability to work well in a constantly changing environment.Bilingual skills in English and Spanish.\n \nMust possess the ability to multi-task between identifying areas for improving patient relations, ensuring that quality standards are met while providing extensive personalized customer service, and executing patient and operational activities. Must demonstrate customer service skills appropriate to the job. Ability to recognize and handle customer complaints. Ability to accurately handle a high volume of work in a fast-paced environment with compassion, patience and positive attitude. Knowledge of pertinent laws, regulations, and guidelines governing medical records, confidentiality, privacy and provisions to others, including HIPAA. Knowledge of ICD-9/ICD-10, CPT, and HCPCS coding sufficient to identify services performed; including diagnoses, procedures, and supplies. Must demonstrate customer / patient service skills appropriate to the job. Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties. Ability to maintain a work pace appropriate to the workload and ability to work well in a constantly changing environment. Strong oral and written communication skills to effectively communicate with patients of varying ages, diagnosis, and multicultural backgrounds. Excellent customer service and strong interpersonal skills. Knowledge of practices and protocols related to medical office procedures (i.e., medical terminology, appointments, medical records, insurance verification, cashiering, billing, etc.)Bilingual skills in English and Spanish.