Job Abstract

Please note: this opportunity will be for approximately two months; potential for extension. 100% on-site at Mt. Zion.

The Patient Financial Clearance (PFC) specialist is a member of the Dermatopathology Service’s patient financial services team. The incumbent is primarily responsible for securing financial clearance for clinical laboratory patients (cases). The PFC specialist verifies patient demographic and insurance eligibility information for each case and enters accurate and complete billing information in the laboratory information system.

The PFC specialist is responsible for working a daily caseload of assigned insurance and authorization cases. Under the general direction of the revenue cycle supervisor, the PFC specialist works independently to resolve payment issues with commercial and government sources that provide healthcare coverage through numerous types of health plans. These plans include traditional indemnity or fee-for-service (FFS) plans; managed care plans like health maintenance organizations (HMO); preferred provider organizations (PPO); and point-of-service (POS) plans. The Dermatopathology Service’s top payors are Medicare, Blue Cross, Aetna, Cigna, United Healthcare, Tricare, and Medicaid.
The PFC specialist has a can-do attitude and a positive mindset. The successful incumbent is a motivated, self-reliant individual who works efficiently and understands the collective goal of the revenue cycle group. The PFC specialist is a team player who works well with the other revenue cycle staff and with the Service’s other administrative and operations staff.

The hourly compensation range for this role is $31.91 - $45.70. An offer will take into consideration the experience of the final candidate, position requirements, AND the current salary level of individuals working at UCSF in a similar role.

Please note: An offer will take into consideration the experience of the final candidate AND the current salary level of individuals working at UCSF in a similar role.

For roles covered by a bargaining unit agreement, there will be specific rules about where a new hire would be placed on the range.

To learn more about the benefits of working at UCSF, including total compensation, please visit: https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html

• Patient financial services experience in a medical practice, diagnostic lab, or in a hospital setting
• Patient financial services experience at a University of California health center or other academic health system
• Knowledge of CPT, ICD 10, and HCPC medical billing codes
• Advanced understanding of payer requirements for Medicare, Medicaid, and HMOs/PPOs
• Familiarity with the Health Insurance Portability and Accountability Act (HIPAA)

• High school graduate or equivalent with four years of medical billing work experience; or bachelor’s degree with six months of medical billing work experience; or equivalent combination of education and experience
• Strong computer skills including desktop operations and keyboard functions; ability to use fax, scanner, and photocopier equipment
• Basic proficiency with Microsoft Office applications including Excel
• Ability to navigate through insurance verification and health plan portals, eg FrontRunner or Availity
• Ability to sit at a computer terminal with telephone headphones for an extended period
• Ability to prioritize case workload, solve billing problems, and meet service time standards
• Possess excellent communication skills including listening, observing, speaking, and writing
• Provide courteous service to all stakeholders including patients, providers, and other clinicians
• Ability to complete assigned caseload efficiently and solve problems with minimal supervision
• Reliable, consistent work attendance and punctuality