Job Abstract

Under the general supervision of the Director of Revenue Cycle Operations Enhancement and Development, representatives will serve as team members on the Patient Responsibility team.

Representatives are responsible for understanding and communicating insurance benefits and financial plans to management, colleagues, clinic staff, and/or patients to support the patient in receiving cost-effective, expedient, and targeted treatment. Representatives are responsible for generating pre-service patient responsibility cost estimates, communicating estimate information to patients, and accepting pre-service patient payments, when applicable.

Generating cost estimates may include pre-service registration and financial clearance activities, such as verifying insurance benefits and eligibility (online, by phone, or fax), determining patient liability information (co-pays, co-insurance, and deductibles), understanding appropriate authorization/referral requirements for scheduled appointments, and/or informing patients of their financial responsibility before their appointment.

Additionally, all representatives will be responsible for answering incoming calls to the phone system and/or emails and providing excellent customer service to patients, UCLA faculty/staff, outside vendors, insurance company representatives, and registration representatives. He/she must demonstrate a positive demeanor, good verbal and written communication skills, and professionalism in both appearance and approach

This is a flex-hybrid role. Each employee must complete a FlexWork Agreement with their manager which will outline arrangement parameters and aids both parties in fully understanding expectations. Arrangements are regularly evaluated, and are subject to termination.

Salary offers are determined based on various factors including, but not limited to, qualifications, experience, and equity. The full salary range for this position is $28.34 - $44.50 hourly. The budgeted salary or hourly range that the University reasonably expects to pay for this position is approximately $35 hourly.

1. Interpersonal skills and ability to communicate effectively and diplomatically with patients, staff and physicians; give and receive information, clarify policies, and mediate if necessary with patients, physicians, and technologists
2. Ability to accept and carry out oral instructions accurately and work independently as well as a part of a team within a demanding environment
3. Ability to prioritize work, handle multiple tasks to completion and make decisions on which course to follow for a particular situation
4. Skill in reading and understanding documents such as training manuals written in English
5. Skill in speaking clearly and distinctly using appropriate vocabulary and grammar; telephone manners to handle heavy phone work with courtesy and tact
6. Ability to work independently and follow through on assignments with minimal direction and supervision.
7. Skill in employing independent decision-making techniques while performing various job duties.
8. Skill in prioritizing assignments to complete work in a timely accurate manner.
9. Ability to adapt and implement frequently changing procedures.
10. Knowledge of medical terminology and the ability to distinguish different exams and medical diagnoses.
11. Knowledge of UCLA registration procedures
12. Knowledge of standard insurance plans (e.g., HMO, PPO, Medicare, Medicaid/MediCal, Workman’s Compensation, etc.)
13. Ability to read and interpret EOB’s
14. Knowledge of how CCI edits, multiple procedures, modifiers and bundling affect expected payments from Medicare and health plans
15. Knowledge and familiarity with the Department and Hospital computer systems, including pre-registration and insurance verification procedures in the appropriate computer system.
16. Ability to proof read and monitor own work for accuracy
17. Demonstrated consistent professional appearance
18. Ability to adapt and implement frequently changing procedures
19. Skill in employing independent decision making while performing various job functions
20. Ability to respond appropriately to emergency situations
21. Understanding of the following front-end Epic applications: Cadence, ADT, and Prelude