Principal Admitting Worker - Ambulatory Care Admin - F/T - Days - 4124
University of California Irvine Medical Center - Orange, CA

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Job Description & Salary Range

UC Title: Principal Admitting Worker

Position Number: 10004186

Reports to: Senior Admin Analyst - Spvr

Working Title: Principal Admitting Worker

Cost Center: Ambulatory Care Admin (8762)

Bargaining Unit: EX

FLSA: Nonexempt

Job Code: 9031

Shift: Day Shift

Hours: 40.00

Position Summary:
Under supervision of the Float Pool Supervisor, incumbent is responsible for all aspects of authorization process from C.C.S., MSI, Medi-Cal, UCIUPS and medical groups other than UCIUPS using established protocol. Utilizes computer programs including but not limited to STARS, ACTS & RTS, Diamond, TDS, Invision, QUEST & other web-based eligibility search engines to verify eligibility and obtain benefit information. As directed by an immediate supervisor may respond to Member Services and Call Center inquiries. Educates clinical staff, physicians and team members about the authorization process as appropriate. The incumbent will be responsible for scheduling patients for surgery and obtaining authorizations. Also acts as a coordinator for patient. Will coordinate all necessary process to ensure patient is ready for scheduled surgery. Assists in determining if the patient‘s source of funding covers proposed surgery and inquires about expiration dates. Assures the physician documentation matches the consent. Obtains surgery date and time based on physician availability and operating room schedule. Communicates effectively with patients in order to obtain demographic and financial data. Provides accurate wait time estimates when available. The incumbent will act as a liaison between admissions and operating room. Notifies departments, services, physicians and patients if surgery date and time is rescheduled and updates all as necessary. Assure accuracy for inputting demographic and financial data into the SMS system. Maintains records and prepares reports as necessary or requested. Updates files as appropriate. Must have the ability to travel.

Salary Range:
Rate Minimum $17.49 Midpoint $19.62 Maximum $21.74

Essential Job Functions:
The identification of essential functions below is not intended to be an exhaustive list of all duties that may be assigned to this position, nor does it restrict the duties which may be assigned to this position if such duties reasonably relate to the position.

% Effort

Responds effectively to questions and concerns expressed by patients and other staff

0%

Obtains demographic information from patients and enters into appropriate computer system

0%

Resolves problems (registration, eligibility, billing or financial) in a timely manner

0%

Reviews cases to determine proper handling and follow-up

0%

Registers patients as appropriate based on type of admission, ensuring the accuracy and completeness of the information

0%

Appropriately schedules, reschedules, cancels or confirms patient appointments in a timely manner to maximize scheduling for patient volume as needed or requested

0%

Ensures appointments conform to established authorizations

0%

Effectively counsels patients regarding insurance and eligibility

0%

Total Effort:
0%

Responsibilities:
Accurately verifies insurance coverage, including Medical Group eligibility

Actively participates on committees and special projects

Answers incoming calls and provides information or directs caller as appropriate

Appropriately determines patient eligibility in relation to established program, insurance or contract standards

Appropriately performs basic reception functions to ensure smooth office operations and patient flow

Appropriately refers patients to correct agencies or offices for service

Appropriately schedules surgery/procedures/diagnostic testing in a timely manner according to patient and physician schedule.

Assists internal customers with patient location, and status updates

Effectively acts as departmental Information Systems User Resource

Effectively collects, compiles, and assembles data from patient records for pre-surgical charts

Effectively collects, complies and assembles data from patient records.

Effectively completes ADF

Effectively copies and distributes documents

Effectively educates clinical staff, physicians and team members about authorization process as appropriate

Effectively represents the department at various meetings and on projects as assigned

Effectively uses all applicable computer software programs as needed or required to ensure accurate and timely delivery of work

Effectively uses computer programs including Diamond, Microsoft Word, TDS Invision and Signature to verify eligibility, obtain benefit information and generate letters for UCIUPS authorizations

Establishes and maintains effective filing systems

Files documents according to unit standards

Gathers information, performs basic analysis and summarizes information in a format suitable for presentation

Independently coordinates administrative processes within the unit

Insures accurate authorization process by consistently completing authorizations from C.C.S. MSI, MediCal, medical groups other than UCIMG

Is independently responsible for a specific support function (as described in the summary statement)

Maintains an accurate database of information and compiles data in timely response to requests for information

Obtains and enters information from appropriate systems, including Invision, ACTS/RTS Diamond, Signature and TDS

Performs data entry accurately and timely

Registers patients as appropriate, ensuring the accuracy and completeness of the information.

Reviews patient's financial status to determine necessary payments and makes appropriate financial or payment arrangements

Takes accurate messages and provides information to callers as appropriate

Required Qualifications:
Demonstrated experience using a computer

Experience in computer software programs such as MS Office

Experience registering patients and filing

Must demonstrate general understanding of medical terminology

Demonstrated knowledge of healthcare insurance

Demonstrate Knowledge of registration, third party payers, government funded programs and managed care

Strong front office experience working in a medical setting

Demonstrated ability to interpret health plan benefit packages and make determinations

Experience in a hospital or medical office setting

Preferred Qualifications:
Demonstrated experience with referral authorization process

Bilingual skills in English and Spanish

Previous Surgery Scheduling and/or Authorization Coordinator experience

Knowledge of ICD-9 and CPT codes

Ability to ensure proper billing or financial procedures for patients ]] >