Principal Access Representative
hace 7 días
Sacramento
___Job ID86065 LocationSacramento Full/Part TimeFull Time ______ 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 5/19/2026 by 11:59pm Minimum Qualifications - For full consideration, applicants are encouraged to upload license and/or certification if required of the position • High School Diploma, GED or equivalent experience., • 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., • Typing skills sufficient to computer keyboard for timely and accurate input and production., • Writing skills, using proper English grammar, spelling, and punctuation, sufficient to compose messages and/or routine correspondence, which is clear, concise, and easy to understand., • Organizing skills to establish priorities for own work within stated guidelines; respond flexibility to changes in priorities; and maintain work effectiveness in a setting with a high volume of patient activity and frequent interruptions., • Coding Certification (CPC or CPC-A), • Any BMT related or Clinical Trial Certification, • EPIC experience, • EMR experience, • Coding and Billing experience, • Authorization and Referrals experience, • 50% - Bone Marrow Transplant Authorizations UC Davis Comprehensive Cancer Center offers comprehensive stem cell transplant services. Our expert team of doctors, nurses, and specialist's guides patients and donors through the process. We provide state-of-the-art facilities for stem cell collection, storage, and safe transplantation within a dedicated Bone Marrow Transplant Unit. Department Specific Job Scope This position in involved in the management and administration of new patient referrals, patient registration, pre-admissions for transplant services, scheduling, insurance eligibility and authorization and referral for services. Services are provided within the Cancer Center and Inpatient Hospital. Functions are provided in concert with clinical and business departments across the organization, to ensure efficient patient flow and to maximize revenue collection. Works closely with revenue cycle, patient financial services, and other ambulatory departments to maintain payer requirements, denial prevention, and continuous process improvement. POSITION INFORMATION • Salary or Pay Range: $31.24 - $38.82, • Salary Frequency: Hourly, • Salary Grade: 235, • UC Job Title: ACCESS REPR PRN, • UC Job Code: 009099, • Number of Positions: 1, • Appointment Type: Staff: Career, • Percentage of Time: 100, • Shift (Work Schedule): 8am-5pm, • Location: Armstrong Building (OTH167), • Union Representation: EX-Patient Care Technical, • Benefits Eligible: Yes 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 ___ or ___ and our ___. 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: • 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, • 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, • 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 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 clearing a criminal background check(s) and may include drug screening, medical evaluation clearance and functional capacity assessment A Culture of Opportunity and Belonging At UC Davis, we're committed to solving life's most urgent challenges and building a healthier, more resilient world. We believe in growing through every challenge, continually striving to improve, and welcoming new perspectives that strengthen our community. We recognize that a vibrant and innovative organization values both individual strengths and shared purpose. The best ideas often emerge when people with different experiences come together. As you consider joining UC Davis, we invite you to explore our ___, our ___ and ___ for research and education. We believe you belong here. The University of California, Davis is an Equal 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. To view the University of California's Anti-Discrimination Policy, please visit: ___ Because we want you to feel seen and valued, our recruitment process at UC Davis supports openness and authenticity. Research shows that some individuals hesitate to apply unless they meet every qualification. You may be an excellent fit for this role-or the next one. We encourage you to apply even if your experience doesn't match every listed requirement. #YouBelongHere To learn more about our background check program, please visit: ___