PRACTICE CRD 2

New Patient Scheduling and Processing 30_ %

• On a daily basis reviews and works referral workqueues documenting activities within the referral record.
• Acts as the primary contact for referring physicians and new patients
• If 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.
• Assigns 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.

Surgery Scheduling ___0 %

• Coordinates scheduling of all outpatient and inpatient surgeries for the surgical practice. Ensures that all surgical procedures are scheduled within a clinically appropriate time frame. Interfaces with patients, physicians and hospital staff to ensure adequate communication regarding all aspects of surgical services.
• Interacts with clinical and academic staff to coordinate surgical activities with physician’s other responsibilities. Processes complex hospital admission forms, schedules pre-surgical tests and appointments, and secures all necessary resources and equipment for surgery.
• Manages complex scheduling coordination related to securing OR time outside of designated block time in the operating rooms. Works to maximize both OR and surgical robots utilization as well as complex joint cases with one or more additional surgeons or other services.

Revenue Cycle 30 %

• 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.
• Demonstrates competency working with CPT codes and 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.
• Monitors provider(s) open charts and encounters and works with providers to complete encounter documentation in a timely manner to support revenue cycle workflow. May assist provider with instructions on how to close encounters opened in error.
• Works RFI workqueues to secure information for accurate billing submissions or to respond to denials such as retro authorizations, clinical documentation, and addended authorizations with add on CPT codes.
• Secures authorization for procedures, specialty visits and ancillary testing and coordinates with Hospital Admissions Department as needed.
• Provide assistance with complex DME authorizations that often require precise documentation in specific formats to receive approval
• Provide assistance with medication authorization for new medications and refills.

Moderate Complex Revenue Cycle 10_ %

Check in / Front Desk: 5_ %

• Greets and welcomes patients making eye contact and utilizing AIDET standards.
• Determines a patient’s co-pay obligation and collects it at the time of the visit; may also collect payments on patient accounts.
• Gives priority to the timely registration of patients on check-in and is aware of the necessity of maintaining practice flow, paying careful attention to the performance improvement initiatives to reduce delays.
• Communicates with patients in a confidential professional manner using tact and diplomacy.
• Monitors and maintains the reception area, making sure it is tidy and there is adequate availability of reading and educational materials. Ensures that the temperature of the reception area is comfortable and that there is adequate and appropriate seating for all patients.
• Observes the waiting area and performs customer service intervention when patients have been waiting a long time or are not receiving adequate service
• Assists patients with use of Kiosk and actively works to promote Kiosk utilization

• Able to create Cadence schedule templates for providers
• Understands how template construction affects access and works to ensure templates is user friendly and help promote consistent clinic access.
• Able to generate reschedule reports in Cadence and work with other members of administrative team to ensure patients are rescheduled in a timely manner to avoid customer service problems.

Administrative and Patient Care Coordination Responsibilities _____5%

• Schedules established patient appointments using Apex and its related components.
• Understands the distinction of each medical practice and how care is delivered in each setting.
• Coordinates appointments with multiple providers as required.
• Discusses practice policies and procedures with patients and referring physicians.
• Answers questions about provider schedules and acts as a resource to other medical center practices and ancillary service administrative staff.
• Has a keen awareness of the need to provide prompt and convenient appointment access to patients.
• Adheres to the provider productivity standards as established in APEX templates for the practice and schedules appointments with the appropriate appointment type.
• Triages all telephone calls, screening for emergencies and routing all messages, requests for same day appointments, refill requests, etc. to the appropriate box.
• Utilizes legacy systems and Apex to retrieve pertinent patient data.
• Follows practice procedure for follow-up of missed appointments.
• Covers Apex in-baskets and phone messages when other members of the team are absent.
• Demonstrates an ability to adjust priorities as required for smooth operation of the practice and notifies the clinical staff.
• Provides administrative support to providers in coordination of patient care (i.e. sending patient letters, educational materials, results of lab tests, etc.)
• Schedules procedures and tests providing appropriate instructions to patients.
• Collaborates with clinical staff in problem-solving patient needs and requests for same day appointments and other appointments requiring care coordination. Works together with the clinical staff in the processing and follow-through of urgent patient needs.
• Demonstrates courtesy and overt helpfulness in all interactions. Collaborates with Practice Supervisor and Administrative Director in the resolution of patient complaints.
• Assists in maintaining current filing and scanning.
• Must have an understanding of multiple clinical symptoms and their associated escalation level with a common sense approach for when it is appropriate to escalate or take action to speed along a process within the practice or to obtain immediate clinical intervention.
• Advanced customer service skills in working with and providing exceptional customer service to patients who are medication dependent and may exhibit challenging behaviors. This includes understanding how to deescalate a difficult encounter and also when to seek additional support from leadership and to protect the safety of the work environment.

Moderate Complex Administrative and Patient Care Coordination Responsibilities 5___ %

APeX and IT Specific Skills 5 %

• Performs the following APEX specific Patient Care Coordinator (PCC) functions as appropriate to completion of APeX PCC training and job duties: Enter new incoming referrals entering authorization information as appropriate Updating and closing CRM messages and converting CRM messages into telephone encounters if practice is serviced by the Ambulatory Services Call Center Open, document within, route and close telephone encounters. Able to accurately utilize documentation steps when leaving a telephone encounter open pending further communications with the caller. Able to utilize smart text logic to document patient phone screening as associated with complex appointment scheduling. Works applicable APeX workqueues to address patient care and service matters Create and send administrative communications via MyChart Create SmartPhrase templates associated with administrative functions Create and route patient letters associated with administrative matters Perform enter/edit outside test results following established workflow and steps Open, document within, route and close telephone encounters. Able to accurately utilize documentation steps with leaving a telephone encounter open pending further communications with the caller. Able to utilize smart text logic to document patient phone screening as associated with complex appointment scheduling. Works applicable APeX workqueues to address patient care and service matters Encourage use of the check in kiosk and trouble shoot technical or customer service issues Pend orders (including med refills, referrals, procedures etc.) associate with a diagnosis and route to provider for review and signature (from preference list only) Pend Smart Sets with proper orders and diagnosis and route to provider for review and signature Modify order class of labs from lab collection vs. clinic collection or UCSF Collect vs. External Collect. Perform advanced appointment scheduling using complex scheduling protocols from a variety of ancillary and subspecialty services some of which will require authorization. Support Patient-Centered Medical Home, Standard 1 guidelines that require patients have daily available appointment access to the practice and if no appointments are available coordinate them at another site or within Adult or Pediatric Urgent Care. Moderate Complex APeX and IT Specific Skills _0 %
• Enter new incoming referrals entering authorization information as appropriate
• Updating and closing CRM messages and converting CRM messages into telephone encounters if practice is serviced by the Ambulatory Services Call Center
• Open, document within, route and close telephone encounters. Able to accurately utilize documentation steps when leaving a telephone encounter open pending further communications with the caller. Able to utilize smart text logic to document patient phone screening as associated with complex appointment scheduling.
• Works applicable APeX workqueues to address patient care and service matters
• Create and send administrative communications via MyChart

Phone Bank 5_%

• Responds to telephone calls from patients seeking medical care at UCSF Medical Center.
• Utilizes the EPIC Appointment Scheduling System (Cadence) to schedule patient appointments in accordance with practice policy.
• Documents call information in the EPIC CRM in a concise, accurate manner.
• Is able to convert CRM messages to telephone encounters according to practice guidelines and workflows
• Responds to patient’s online Web appointment requests for patients utilizing the online appointment system.
• Utilizes Phone Bank protocols to determine when to involve a clinician on a call due to urgent or emergent symptomatology.

General Performance 1______ %

• As assigned, pulls and prepares charts prior to patient appointment following established practice criteria.
• Files all patient related information, tracks incoming slides, films and reports as required by practice; returns materials to referring physicians in a timely manner utilizing tracking systems.
• Scans and imports patient records and documents in APeX system following established guidelines and policies.
• Upholds UCSF Medical Center policy regarding the maintenance and confidentiality of medical records and other patient information. Maintains and adheres to patient confidentiality and HIPAA guidelines including the distribution of NOPPs (Notice of Privacy Practices).
• Participates in team building by actively contributing during meetings and with staff and providers in discussion of all practice activities.
• Attends training classes provided by Medical Center, Billing Agent, and others as necessary. Bring information back to practice and use on the job.
• Works with supervisor and co-workers to ensure that the practice responds comprehensively to patient care needs through improved procedures and administrative systems. Is an active participant in performance improvement projects and customer service initiatives.
• Complies with all Medical Center and Ambulatory Services procedures for infection control, safety, administrative and clinical practice. Complies with activities mandated by Joint Commission, Title 22.
• As assigned, fills in for other co-workers to help address work load problems and cover vacation or sick leave openings.
• Maintains provider calendars
• When working in a primary care practice, assists with the delivery and maintenance of a high standard of patient care using the Patient Centered Medical Home model which emphasizes the care of the “whole patient” which includes in-reach, outreach and intensive follow up on referrals.
• When working within the primary care environment acts as the coordinator for all of patient’s needs such as forms (ie. work release, disability, immunization records, etc.) and is principally responsible for the continuity of care for patients which includes a significant amount of support for patients at the time of the visit and between visits.
• Provides 1:1 and team training for new hires and new initiatives and procedures

Moderate Complex General Performance 1_____ %

Environmental Responsibilities: _1 %

• Reports any malfunctioning of equipment.
• Complies with recommendations made by ergonomic specialists to avoid workplace injury
• Complies with infection control policies related (e.g. does not eat at the front desk or in patient care areas)
• Serves as practice deputy for life / safety activities helps lead drills

Moderate Complex Environmental Responsibilities _1 %

Customer Service Outreach 1__ %

• Deals directly with patients either by telephone, electronically or face to face while consistently following EVERYDAY PRIDE principles in verbal and written communications
• Responds promptly and courteously to internal and external inquiries. Stays logged into appropriate APeX Pools and In Baskets.
• Handles front line patient complaints with the support of the Practice Supervisor / Administrative Director
• Supports all performance improvement initiatives as outlined by the Medical Center leadership through active participation and initiation
• Obtains and evaluates all relevant information to handle inquiries and complaints
• Strong team player, has a dedicated work ethic, and is willing to learn and adapt to new tasks when asked. Comfortable building rapport with patients quickly and is able to work effectively with and without supervision and remain calm and friendly in all interactions with patients
• Notifies providers of patient delays and service issues. Acts and advocate for patients to help facilitate provider punctuality in seeing patients according to schedule.
• Communicates provider delays with front office team and makes regular announcements to waiting room as needed when delays are over 30 minutes.
• Offers suggestions for change or improvement in clinic/practice operations.
• Leads by example in the areas professional appearance, demeanor and body language, making eye contact with patients and internal customers, exhibits a friendly demeanor to put patients at ease.
• Seeks opportunities to improve patient convenience. Utilizes service recovery amenities as appropriate. Contributes to the development of a patient-focused environment.

• Demonstrates service excellence by following the Everyday PRIDE Guide with the UCSF Medical Center standards and expectations for communication and behavior. These standards and expectations convey specific behavior associated with the Medical Center’s values: Professionalism, Respect, Integrity, Diversity and Excellence, and provide guidance on how we communicate with patients, visitors, faculty, staff, and students, virtually everyone, every day and with every encounter. These standards include, but are not limited to: personal appearance, acknowledging and greeting all patients and families, introductions using AIDET, managing up, service recovery, managing delays and expectations, phone standards, electronic communication, team work, cultural sensitivity and competency.
• Uses effective communication skills with patients and staff; demonstrates proper telephone techniques and etiquette; acts as an escort to any patient or family member needing directions; shows sensitivity to differences of culture; demonstrates a positive and supportive manner in which patients / families/ colleagues perceive interactions as positive and supportive. Exhibits team work skills to positively acknowledge and recognize other colleagues, and uses personal experiences to model and teach Living PRIDE standards.
• Exhibits tact and professionalism in difficult situations according to PRIDE Values and Practices
• Demonstrates an understanding of and adheres to privacy, confidentiality, and security policies and procedures related to Protected Health Information (PHI) or other sensitive and personal information.
• Demonstrates an understanding of and adheres to safety and infection control policies and procedures.
• Assumes accountability for improving quality metrics associated with department/unit and meeting organizational/departmental targets.

• Keeps working areas neat, orderly and clutter-free, including the hallways. Adheres to cleaning processes and puts things back where they belong. Removes and reports broken equipment and furniture.
• Picks up and disposes of any litter found throughout entire facility.
• Posts flyers and posters in designated areas only; does not post on walls, doors or windows.
• Knows where the Environment of Care Manual is kept in department; corrects or reports unsafe conditions to the appropriate departments.
• Protects the physical environment and equipment from damage and theft.

• Demonstrates innovation and flexibility regarding the modification of tasks or workflows within assigned duties and job functions
• Perform other duties as assigned
• Other clerical duties as assigned

• High School graduate or equivalent with four years related experience; or college degree and 6 months related experience; or equivalent combination of education and experience.
• Successfully passes fingerprinting protocol and is approved to be a cash collector if applicable.
• Strong computer skills, including basic keyboarding skills, and experience with at least two Office-type software programs (i.e., Outlook, Word and Excel). Proven ability to navigate through multiple patient records systems. Able to sit at a computer terminal with telephone headphones for extended period of time.
• Ability to analyze situations, prioritizes, and develops solutions and makes recommendations.
• Ability to work with minimal supervision
• Ability to use good judgment and work independently, at times under the pressure of deadlines
• Ability to access situations prioritizes workload, develop solutions and make recommendations.
• Excellent customer service and communication/interpersonal skills, both over the telephone and directly.
• Able to sit at a computer terminal with telephone headphones for extended periods of time.
• Basic math skills required.
• Proven ability to deal with a wide variety of individuals;
• Ability to deal sensitively and effectively with patients.
• Excellent organizational and problem-solving skills.
• Strong writing skills to include the ability to compose, edit, and proof a wide variety of documents.
• Demonstrated administrative/office coordination skills.
• Demonstrated knowledge of medical practice terminology.
• Within six months of start date, based upon completion of training, the Supervisor, completes the proficiency checklist with the employee. This includes the following areas if applicable Referrals (Incoming referral entry) and handling all referral WQs Pend orders Pend smart sets Schedule surgeries Work applicable work queues Enter/edit outside test results Messaging (CRM) if applicable 2 nd calls in CRM if applicable Telephone encounters My open encounter Staff message New message Route Patient advice request to providers (My Chart) Patient Schedule (My Chart) Letters Pools Patient look up Check in process Check out process Comment field Quick note Scanning
• Referrals (Incoming referral entry) and handling all referral WQs
• Pend orders
• Pend smart sets
• Schedule surgeries
• Work applicable work queues
• Enter/edit outside test results
• Messaging (CRM) if applicable
• 2 nd calls in CRM if applicable
• Telephone encounters
• My open encounter
• Staff message
• New message
• Route Patient advice request to providers (My Chart)

• Letters
• Pools
• Patient look up
• Check in process
• Check out process
• Comment field
• Quick note
• Scanning

• Demonstrated experience in health care (may include medical, dental or veterinary) in the following areas: patient scheduling, insurance verification, medical record data abstraction, or patient financial services.
• Prior experience with appointment, ancillary service or surgical scheduling or a combination of all three.
• Bi-lingual or multi-lingual capability (Spanish, Cantonese, and Russian) strongly preferred.
• Prior experience with EPIC.

• N/A