Access Representative Principal

The incumbent for this position is primarily responsible for the analyzing of records, to include bone marrow transplant, donor, and recipient methodologies for the purposes of verifying eligibility, processing referrals, submitting authorizations, and following up on complex bone marrow transplant cases. This is a resource to the Cancer Center Bone Marrow Transplant Authorization Coordinators, Billing, Coding, Accounts Receivable, Financial Clearance Departments, and other key UC Davis revenue cycle departments. This position requires the skills and ability to manage the level of responsibility and accountability necessary to provide guidance for the department/clinical team for which it is assigned. This position must serve as a subject matter expert and resource person for a small group of MOSC 1, MOSC 2, MOSC 3, and/or other complex service lines. This position is responsible to act as a liaison with insurance companies, contract office, and in-patient and out-patient areas associated with care delivery for the transplant or clinical trial process for the adult population. Works with contract office if individual contracts are needed. Keep appropriate records that are involved in the authorization approval or denial processes. Works directly with patients when needed to explain and guide them through the process. Assists with denials taskforce for prevention of claim denials related to authorization. Responsible to maintain and manage a high-volume in-patient and out-patient referrals.

Apply By Date 12/28/2024 by 11:59pm

Minimum Qualifications - For full consideration, applicants are encouraged to upload license and/or certification if required of the position

• Two (2) years of experience coding and/or obtaining authorizations for Bone Marrow Transplant, Clinical Trial, or Oncology related services.
• Knowledge of ICD-10 and HCPS coding sufficiently to identify services performed, including diagnosis, procedures, and supplies.
• Knowledge of practices and protocols related to medical office procedures, (i.e., medical terminology, appointments, medical records, insurance verification, cashiering, billing, etc.).
• Knowledge of health care insurance systems, which may include Medi-Cal, MediCare, HMO, PPO, fee-for-service, county funded coverage, and workers compensation, sufficient to properly obtain and track authorizations, appoint patients, make referrals for consults, diagnostics and ancillary services, coordinate hospital services, complete and submit billing documentation, and explain provisions and requirements to patients.
• Demonstrates leadership skills that reflect the ability to serve as the coordinator of the specified unit of workers and must be able to represent the team and be a subject matter expert and resource person for staff.
• Ability to accomplish a variety of concurrent assignments in an effective and efficient manner, demonstrating ability to organize, prioritize and complete assignments in a designated timeframe. Ability to adjust to changing workload or assignments and pressures of increased workloads or deadlines. Ability to work independently, prioritize and meet deadlines.
• Problem solving skills to independently define a problem identify the resources available to help solve the problem, create viable solutions, and take the necessary action to implement problem resolution and ensure prompt and satisfactory resolution. Ability to accomplish or complete a task to demonstrate in detail all areas involved.
• Decision making skills to independently exercise delegated authority to take action and to appropriately see assistance from others when limits of delegated authority have been reached.
• Interpersonal skills to establish and maintain effective working relationships with all co-workers; to consistently interact with patients and other members of the public with patients, courtesy, and professionalism, both in person on the telephone; and to effectively respond to individuals who may be angry or upset.
• Ability to efficiently use computer system applications for al functions required for this position, including electronic email, spreadsheets, word processing, and medical office management.

Preferred Qualifications

• Coding Certification (CPC or CPC-A)
• Any BMT related or Clinical Trial Certification
• High School Diploma, GED or equivalent experience.
• EPIC experience
• EMR experience
• Coding and Billing experience
• Authorization and Referrals experience
• Demonstrated knowledge of medical terminology

Key Responsibilities

• 50% - Bone Marrow Transplant Authorizations
• 50% - Bone Marrow Transplant Billing and Denial Management

Department Overview

Stem Cell Transplant Authorization Financial Coordinator in BMT Transplant Program.

POSITION INFORMATION

• Salary or Pay Range: $29.75 - $36.97
• Salary Frequency: Hourly
• Salary Grade: 235
• UC Job Title: ACCESS REPR PRN
• UC Job Code: 009099
• Number of Positions: 2
• Appointment Type: Staff: Career
• Percentage of Time: 100%
• Shift Hours: 8am-5pm
• Location: Armstrong Building (OTH167)
• Union Representation: Yes EX-Patient Care Technical
• Benefits Eligible: Yes
• This position is 100% on-site

Benefits

Outstanding benefits and perks are among the many rewards of working for the University of California. UC Davis offers a full range of benefits, resources and programs to help you bring your best self to work, as well as to help you and your family achieve your health, wellness, financial and career goals. Learn more about the benefits below and eligibility rules by visiting either our handy Benefits Summary for UC Davis Health Employees or Benefits Summary for UC Davis Employees and our Benefits Page.

If you are represented by a union, benefits are negotiated between the University of California (UC) and your union and finalized in a contract. Read your bargaining unit's employment contract, stay abreast of current negotiations and learn about collective bargaining at UC: https://ucnet.universityofcalifornia.edu/labor/bargaining-units/index.html

* High quality and low-cost medical plans to choose from to fit your family's needs
* UC pays for Dental and Vision insurance premiums for you and your family
* Extensive leave benefits including Pregnancy and Parental Leave, Family & Medical Leave
* Paid Holidays annually as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement
* Paid Time Off/Vacation/Sick Time as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement
* Continuing Education (CE) allowance and Education Reimbursement Program as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement
* Access to free professional development courses and learning opportunities for personal and professional growth
* WorkLife and Wellness programs and resources
* On-site Employee Assistance Program including access to free mental health services
* Supplemental insurance offered including additional life, short/long term disability, pet insurance and legal coverage
* Public Service Loan Forgiveness (PSFL) Qualified Employer & Student Loan Repayment Assistance Program for qualified roles
* Retirement benefit options for eligible roles including Pension and other Retirement Saving Plans. More information on our retirement benefits can be found here
* UC Davis cares about building a community, which is why we provide resources to enhance diversity, equity and inclusion as well as Employee Resource Groups (ERGs) to support our staff

Physical Demands

• Standing - Occasional Up to 3 Hours
• Walking - Occasional Up to 3 Hours
• Sitting - Frequent 3 to 6 Hours
• Lifting/Carrying 0-25 Lbs - Occasional Up to 3 Hours
• Pushing/Pulling 0-25 Lbs - Occasional Up to 3 Hours
• Bending/Stooping - Occasional Up to 3 Hours
• Squatting/Kneeling - Occasional Up to 3 Hours
• Twisting - Occasional Up to 3 Hours
• Reaching overhead - Occasional Up to 3 Hours
• Keyboard use/repetitive motion - Frequent 3 to 6 Hours

Mental Demands

• Sustained attention and concentration - Frequent 3 to 6 Hours
• Complex problem solving/reasoning - Occasional Up to 3 Hours
• Ability to organize & prioritize - Frequent 3 to 6 Hours
• Communication skills - Frequent 3 to 6 Hours
• Numerical skills - Occasional Up to 3 Hours
• Constant Interaction - Frequent 3 to 6 Hours
• Customer/Patient Contact - Frequent 3 to 6 Hours
• Multiple Concurrent Tasks - Frequent 3 to 6 Hours

Work Environment

• UC Davis is a smoke and tobacco free campus effective January 1, 2014. Smoking, the use of smokeless tobacco products, and the use of unregulated nicotine products (e-cigarettes) will be strictly prohibited on any UC Davis owned or leased property, indoors and outdoors, including parking lots and residential space.
  
  

Special Requirements - Please contact your recruiter with questions regarding which activities apply by position

• This is a critical position, as defined by UC policy and local procedures, and as such, employment is contingent upon successful completion of background check(s), including but not limited to criminal record history background check(s)
• This position is designated as a mandated reporter under CANRA and UC policy, and employment is contingent on compliance with applicable policies, procedures and training requirements
• Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.

Diversity, Equity, Inclusion and Belonging

At UC Davis, we're solving life's most urgent challenges to bring a fuller, healthier, and more resilient world within reach. We grow from every challenge we take on and we don't just maintain - we improve. We recognize that creating an inclusive and intellectually vibrant organization means understanding and valuing both our individual differences and our common ground. The most comprehensive solutions come from the most diverse minds and you belong here. As you consider joining UC Davis, please explore our Principles of Community, our Clinical Strategic Plan and strategic vision for research and education, and our latest efforts to outgrow the expected. The University of California, Davis is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status.

For the University of California's Affirmative Action Policy, please visit: https://policy.ucop.edu/doc/4010393/PPSM-20

For the University of California's Anti-Discrimination Policy, please visit: https://policy.ucop.edu/doc/1001004/Anti-Discrimination

Because we want you to be seen, our recruiting process at UC Davis fosters authenticity, diversity, and inclusion. Studies have shown that some people may not apply to jobs unless they meet every single qualification. Each unique role at UC Davis has a set of requirements and you could be perfect for this role, or you could be perfect for the next role! Don't meet all the requirements? We still encourage you to apply! #YouBelongHere

To learn more about our background check program, please visit: https://hr.ucdavis.edu/departments/recruitment/ucd/selection/background-checks