Practice Coordinator

%

of time

Essential Function (Yes/No)

Key Responsibilities

(To be completed by Supervisor)

35

Client Scheduling and Check-in:

• Creates a professional and positive first impression for clients and referring physicians. Demonstrates good judgment and common sense.

• On a daily basis, schedules and registers clients 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 clients are seen within prescribed timelines. Communicates any problems with the schedule with supervisor.

• Registers new clients and confirms existing client demographics by collecting client detailed information including personal and insurance information.

• Understands eligibility of each client and what level of service their coverage allows (UC SHIP, non-UC SHIP, reciprocity, dependent, couples, etc.).

• Verifies students who have waived UC SHIP to confirm they have active coverage and make them aware of their client responsibility.

• Protects clients' privacy by maintaining confidentiality of personal and financial information and all PHI/ePHI.

• Gives priority to the timely registration of clients on check-in and is aware of the necessity of maintaining practice flow, paying careful attention to the performance improvement initiatives to reduce delays.

• Promotes efficient workflow by making sure students are checked-in properly, all pre-visit requirements are completed such as filling out health history/questionnaires and checking eligibility, and that the rest of the care system functions efficiently. Communicate about any delays to the student and communicate with other staff if the workflow is disrupted to resolve.

• Ensures consent forms have been completed for any health care service requiring consent and provide client with information handouts as appropriate.

• Communicates with clients in a confidential professional manner using tact and diplomacy.

• Answers phones while maintaining a polite, consistent phone manner using proper telephone etiquette.

• Observes the waiting area and performs customer service intervention when clients have been waiting a long time or are not receiving adequate service.

• Notifies providers of client delays and service issues. Acts and advocates for clients to help facilitate provider punctuality in seeing clients according to schedule.

• Addresses and resolves escalated issues of day-to-day operations (e.g. customer service, provider complaints, cross departmental communication or coordination problems, etc.)

• Obtains and evaluates all relevant information to handle inquiries and complaints.

• Handles front line client complaints with the support of the Practice Manager

• Serves as first line of triage (non-clinical) for all presenting students, visitors, vendors or non-SMHW university employees. This requires knowledge of space access policies, in-depth knowledge of all functions of the practice to assist students in obtaining care, and high-level customer service skills.

• Be able to interact with anxious clients in a comforting manner and work to alleviate anxieties by providing clear, concise information and when needed facilitating access to the appropriate clinical provider.

• Seeks clinical input when appropriate.

• Helps clients in mental health distress by escalating care to the triage practitioner.

• Offers suggestions for change or improvement in clinic/practice operations.

• Secures outside medical records, review them for completeness, and makes a determination as to which physician can best evaluate the client.

• Understands, upholds and explains all departmental policies and procedures in clear and concise manner. Recommends changes or updates to policies and procedures or new policies and procedures based on observed needs.

• Reports systems issues to management for process improvement or review.

• Identifies students’ needs by formulating appropriate questions to assess and resolve the issues or concerns.

• Secures outside medical records, i.e. CD’s of scans or other records; reviewing them for completeness; and ensuring it is given to the appropriate provider.

40

Administrative and Client Care Coordination Responsibilities:

• Coordinates appointments with multiple providers as required.

• Discusses practice policies and procedures with clients 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 clients.

• Adheres to the provider productivity standards as established in EMR 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.

• Follows practice procedure for follow-up of missed appointments.

• Works electronic medical records (EMR) work queues to address client care and service matters.

• Adjusts priorities as required for smooth operation of the practice and notifies the clinical staff.

• Provides administrative support to providers in coordination of client care (i.e. sending client letters, educational materials, copy of lab tests results, etc.).

• Provides assistance with medication authorization for new medications and refills.

• Schedules appointments, providing appropriate instructions to clients.

• Collaborates with clinical staff in problem-solving client 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 client needs.

• Collaborates with Practice Manager and Clinical Director in the resolution of client complaints. Performs role in a courtesy and helpful manner in all interactions.

• Assists in maintaining current filing and scanning.

• Escalates or takes action to speed along a process within the practice or to obtain immediate clinical intervention as needed. Assesses unique client circumstances. With an understanding of multiple clinical symptoms and their associated escalation level, exercises a commonsense approach for when it is appropriate to escalate.

• Provides advanced customer service when working with clients 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.

• Identifies referral problems; reports out to management team with suggested solutions.

• Understands and adheres to all HIPAA and FERPA standards for the management of protected health information (PHI).

• Be proficient in the use of the EMR (electronic medical records) for all core functions of managing health information. Includes appointment scheduling, creating notes, scanning documents, looking up labs and other clinical data, researching historical information, and accessing other critical pieces of healthcare information.

• Organizes medical information in chart according to protocol. The electronic chart has many sections and information needs to be filed in the correct section of the chart consistently and accurately.

• Completes specialty referrals and authorizations accurately and in a timely manner.

• Creates new mental health referrals entering authorization information as appropriate.

• Identifies and troubleshoots technical and procedural issues within the EMR. Communicates findings to supervisor and the I.T. staff so fixes to problems and communication about procedures can be implemented in a timely manner.

• Works with specialty physician offices to obtain and process insurance authorization for students. This involves scanning paper information and linking information from other electronic sources.

• Manages clinical notes from UCSF departments and other specialists providing clinical care for acknowledgment by SMHW providers. Processes additional referral requests according to protocol.

• Manages radiology reports from UCSF Department of Radiology and other imaging service companies for acknowledgment by SHCS providers. Processes additional referral requests according to protocol.

• Scans and files clinical information received in paper form into the EMR. This requires using software to move electronic files to the EMR and scanning to place paper forms in the chart.

• Researches and obtains labs results missing from the EMR.

• Processes telephone and faxed prescription refill requests.

• Processes Needle Stick Reports from UCSF Occupational Health for acknowledgment by Executive Director and insurance authorization.

• Direct clients to the “MyHealthRecord.ucsf.edu” online student portal to securely print their immunization history, schedule and cancel appointments, and communicate with their SMHW providers.

• Creates and routes client letters associated with administrative matters.

• Creates TextMacro templates associated with administrative functions.

• Works to improve processes and communication with major referral facilities, providers and the insurance company.

• Records and processes medical records requests from outside providers, individuals, or third parties including subpoena requests. This includes the completion of the “Authorization for Release of Health Information” form and making notations of all disclosures.

• Works as part of the administrative team on clinical process improvements related to the EMR and other clinic issues.

• Makes recommendations, reviews and assists with policies and procedures to more effectively reflect clinic practices.

• Creates medical record charts for adult dependents enrolled in the UC SHIP voluntary plan and reciprocity students.

• Is skilled and able to help students/clients book Specialty appointments by calling the department directly and providing insights about navigating UCSF to meet their health needs.

10

Insurance, Billing, and Financial / Revenue Cycle:

• Obtains “expert” level knowledge of UC SHIP insurance benefits and claims process in order to advise students and answer questions.

• Educates students in all key aspects of Covered CA (ACA) insurance plans. Assist students with questions related to Covered CA and be able to compare and contrast the UC SHIP with any level of Covered CA plan.

• Ensures necessary data is collected to facilitate billing UC SHIP and non-UC SHIP insurance plans.

• Answers student questions concerning insurance coverage or benefits. Proactively educate students about insurance plan when opportunities present.

• Communicates administrative and financial policies clearly to client, answering client account questions. Assesses situation and refers clients to financial counseling, billing agents, client relations or other support departments for additional help if needed.

• Accesses the online enrollment manager and medical vendors’ eligibility system for issuance of temporary ID cards and coverage confirmation.

• Understands how to identify and interpret a client’s UC SHIP insurance benefit, including pharmacy and mental health carve outs. Utilizes this information to direct authorization requests and to coordinate these services for clients.

• Understands the concept of managed care and is knowledgeable about the resources available to the student. Assists clients to understand the concept of managed care.

• Explains to students the various online tools available to them and be able to refer them to vendor websites to manage insurance claims, find specialty providers, and compare costs.

• Works collaboratively with the Operations Manager to process student waivers each term. Accountable for first line review and student communications. Brings outstanding cases and appeal to Review Committee.

• Assists students with the health insurance waiver and waiver cancellation process. Refers students to forms related to insurance enrollment and the waiver process and be able to accurately refer students to the correct form.

• Communicates the availability and benefits of the Student Health Dependent Insurance Plan to potential enrollees.

• Identifies instances where students might benefit from utilizing the UC System-wide reciprocity agreement and communicate the benefits extended to UCSF students at their host campus as well as the benefits non-UCSF students are granted at UCSF.

• Assists students in resolving issues with billing and health insurance claims problems.

• Educates students concerning complex insurance benefit details and terminology as well as paperwork generated by their billing history.

• Maintains in-depth knowledge of referral, care delivery, billing, and claims payment processes in order to support all insurance related responsibilities.

• Serves as a liaison to the insurance enrollment manager for student eligibility.

• Serves as liaison to medical, dental, pharmacy, and vision care vendors on coverage and billing issues related to UC SHIP.

• Accesses the online enrollment manager and medical vendors eligibility system for issuance of temporary ID cards and coverage confirmation.

• Serves as liaison to UCSF Health billing units on behalf of students with insurance claims issues.

• Makes process improvement recommendations related to insurance coverage and billing processes.

• Fulfills functions of SMHW Cashiering Substation. Responsible for the collection and accounting of all cashiering funds and compliance with the SMHW written cashiering policy. Must be a certified cashier requiring fingerprinting and taking cash handling test.

• Processes credit card transactions in compliance with established University policy.

• Maintains records for cash receipts and other payments made by students

• Manages collection and payment of premiums for Scholars and Researcher Health Plan.

• Reconciles cash collections daily, balance cashiering log and adjust for deposits, make deposits, process analysis of cash and check collections and create journals to process deposits.

• Reviews all upcoming visits to determine client eligibility and assists with transitioning clients who are no longer eligible to new mental health care through collaboration with the practice clinical teams.

• DepartmentServes as department resource for insurance questions and insurance updates.

5

Immunization Program:[UK1]

Communicates

• Provides assistance to the Student Communicable Disease Program (SCDP) team (immunization and TB screening standards to students.

• Assesses immunization and TB history data for compliance)

• Manages a group of UCSF students and their compliance with UCSF standards for immunization and tuberculosis screening. Ensure holds in the Registrar’s data system are correct. Explain to students how the Student Information Portal (maintained by SIS and Registrar) works, can be accessed and how to check in the system if they have a hold.

• Assesses accuracy of historical immunization and TB records from outside providers and patients and as necessary; enter data into EMR to reflect the patients’ immunization and TB history. Attention to detail is necessary to ensure all health requirements are satisfied for clinical rotations.

• Communicates with nursing staff concerning complex immunization or TB histories or non-standard cases.

• Explains to students the process by which they gather and submit health requirements. Includes explaining how to access the secure online immunization portal and what students can expect from a visual perspective upon entering.

• Provide support to new and continuing student: how to upload documents onto the OHS portal

• Responds to student inquiries as to the status of their pre-entrance health requirements and offers guidance on what needs to be done for outstanding items to be completed.

• Communicates accurately new and continuing student immunization and TB screening requirements.

Assists in communicating the PPD test schedule and process to all registered students.

5

Environmental Responsibilities:

• Monitors and maintains the reception area, making sure it is tidy and there is adequate availability of reading/educational materials. Ensures that the temperature of the reception area is comfortable and that there is adequate and appropriate seating for all clients.

• Reports any malfunctioning of equipment.

• Complies with recommendations made by ergonomic specialists to avoid workplace injury.

• Complies with all infection control policies (e.g. does not eat at the front desk or client care areas).

5

Special Projects and Administration:

• Participates in bi-monthly Administrative Team meetings by contributing ideas to more effectively manage day-to-day operations and improve clinic practices.

• Takes on ad hoc projects as assigned including syncing of providers’ clinical and Outlook calendars, assisting with new software implementation, review of data for quality projects or operational assessment, etc.

• Maintains business office inventory and equipment by checking stock to determine inventory level; anticipating needed supplies; placing and expediting orders for supplies; verifying receipt of supplies; scheduling equipment service and repairs.

• Submits purchase requests via the BearBuy online purchasing system. Be familiar with policies and procedures governing the use of the site.

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