Responsible for ensuring efficient administrative operations in coordination with leadership. Responsible for obtaining approval of professional and technical services, which may include obtaining insurance referrals, procedure authorizations or pre-certifications required for patients to receive physician services, medical procedures, equipment, supplies and medications.

• Works in conjunction with office managers and clinic staff at multiple locations as assigned to facilitate administrative operations and provide support.
• Provides EMR education and support to CPG clinic staff in a trainer capacity. Functions as an EMR Super User subject matter expert to ensure staff is trained in the EMR system. Facilitates dissemination of system upgrades and updates to administrative staff.
• Demonstrates expected behaviors applicable to UPG, scheduling and registration system, as well as unit policies, procedures and guidelines. Utilizes electronic medical record functionality (e.g., inbox, telephone encounters, prescription requests, pools, letters and documentation only) per department process guidelines.
• Registration elements, including Medicare Secondary Payor Questionnaire (MSPQ), scanning of long-term signatures (LTS) and insurance cards, Advanced Beneficiary Notices (ABNs), waivers and financial screenings are completed when indicated and in a timely manner.
• Obtains referrals, authorizations and pre-certifications through a work queue process flow and Epic lists to ensure required approvals are obtained within an established time standard.
• Reviews and evaluates documentation of electronic medical records (EMR) to obtain medical necessity and clinical data for approvals.
• Ensures referrals are attached to appointments and the appropriate insurance information is documented. Researches and updates insurance carrier requirements as necessary.
• Provides exceptional customer service while assisting customers in obtaining access to Medical Services at UVA Health System. Develops understanding of complex patient scheduling needs to facilitate optimal patient experience that meets individual needs. Maintains a positive attitude when speaking with customers and internal and external service representatives. Greets callers pleasantly and courteously; answers telephone as per department standards. Serves as a role model for UPG core values and ASPIRE while maintaining and expanding patient relationships. Demonstrates ownership of own role in the patient/family experience.
• Prioritizes tasks to meet customer needs. Describes the impact of own performance on patient satisfaction.
• Answers telephones, screens calls, confirms appointments and, maintains appointment schedule following office scheduling procedures. Refers callers to appropriate individuals, and gives routine information in accordance with established procedures.
• Administers patient "no shows" and "cancellations" according to office policy; calls to reschedule as appropriate. May follow up with letter to patients for those unable to contact.
• Responsible for obtaining approval of professional and technical services, which may include obtaining insurance referrals, procedure authorizations or pre-certifications required for patients to receive physician services, medical procedures, equipment, supplies and medications.
• Other projects and/or assignments as directed.

MINIMUM REQUIREMENTS

• Education: High school diploma or GED.
• Experience: Three years of experience with preauthorization and referral processing.
• Licensure: None.
• Skills: Basic knowledge of and experience utilizing a personal computer. Basic word processing skills required. Must have ability to learn and use telephone, facsimile and copy machine systems. Ability to work independently with minimal supervision and to manage multiple priorities. Strong analytical, prioritization and organizational skills.

PHYSICAL DEMANDS
This is primarily a sedentary job involving extensive use of desktop computers. The job does occasionally require traveling some distance to attend meetings and programs.

COVID Vaccination Requirement and Guidelines

 

Please visit the UVA COVID-19 Job Requirements and Guidelines webpage prior to applying for current information regarding vaccination requirements and guidelines for employment at UVA.