Reports to the Patient Access Supervisor and is guided by the procedures of inpatient and outpatient services. The Registration/UM Coordinator supports all intensive services—Inpatient, Partial Hospitalization, Intensive Outpatient Program, consult Liaison and Electroconvulsive Therapy—for patients at Langley Porter Psychiatric Hospital (UCSF Health). Responsibilities include reception, registration, insurance coverage verification, relaying financial information, providing financial need applications, and patient processing. The Coordinator also supports the Utilization Review Coordinator by analyzing patient records to determine admission legitimacy, length of stay, and insurance reimbursement compliance. The role receives objectives and goals, serving as a clinical resource and liaison for patients and families and assisting with navigating all aspects of the healthcare system.
Responsibilities
- Communicates administrative and financial policies to patients, answers account questions, and refers patients to financial counseling, billing partners, patient relations, or other support departments when needed.
- Obtains and documents insurance authorizations for established patient visits, referrals, and procedures or ancillary services; communicates clinical information from medical records authorization requests to insurance companies.
- Works RFI work queues to secure information for accurate billing submissions and respond to denials such as retro authorizations, clinical documentation, and addenda with CPT codes.
- Secures prior authorization for procedures, specialty visits, and ancillary testing and coordinates with the Hospital Admissions Department as needed.
- Collects and verifies insurance and referral/authorization information for first appointments, ensuring referral records and Hospital Accounts Records (HARS) are created and assigned to the appointment.
- Secures complex insurance authorizations for services, medications, or testing and tracks authorizations for renewal based on insurance company limits or time frames.
- Understands and interprets a patient’s insurance benefit package, including pharmacy and mental health carve‑outs.
- Addresses patient complaints regarding billing and complaints that arise from Patient Relations.
- Understands managed care concepts, is knowledgeable about staff resources, and assists patients in understanding managed‑care requirements.
- Other duties as assigned.
- Manages patient expectations by providing mental‑health–specific guidelines related to service/visit.
- Obtains appropriate consents, PAFRs, and signed documents at first visit.
- Creates a professional and positive first impression for patients and referring physicians, demonstrating good judgment and common sense.
- Maintains confidentiality and HIPAA guidelines, distributing Notice of Privacy Practices (NPP) and Patient Financial Responsibility form (PAFR).
Qualifications
- Flexibility to orient and work at all UCSF Medical Center locations.
- One year of related experience.
- Bachelor’s degree in a related area and/or equivalent experience/training.