Quality Commission Trainer - Financial Clearance Unit

Quality Commission Trainer

Work Location: Los Angeles, CA, USA

Onsite or Remote Flexible Hybrid Work Schedule Monday - Friday, 9:00am-5:30pm PST

Salary Range: $31.51 - $62.64 Hourly

Employment Type 2 - Staff: Career Duration Indefinite Job # 29101

Primary Duties and Responsibilities

Under the general supervision of the manager and Financial Clearance Unit senior leadership, the Quality Commission Trainer will be responsible for:

• Evaluating and providing supportive and constructive feedback to UCLA's Financial Clearance Unit on the Quality Reviews (QRs) they perform for representatives
• Ensuring that supervisors are performing consistent and accurate QRs across all units and ensuring representatives receive consistent and fair reviews and supervisors provide tangible, data driven feedback
• Supporting department training efforts for new staff members, maintaining training materials, identifying and filling training gaps to ensure high quality work, and providing quality review coverage to supervisors with answering busy phone system; sending out comprehensive trending reports
• In-depth knowledge and understanding of health plan benefit coverage levels/authorization information; assisting in pre-registration for the appropriate clinics; verifying insurance billing addresses; photocopying; faxing; sorting mail; and special projects as assigned
• Assisting with training desk staff on CareConnect (Missing Registration and Insurance Verification) work flow process and other applicable needs
• Providing excellent customer service to patients, faculty/staff, including outside vendors, insurance company representatives and registration representatives

Note: This posted position is 1 of 1 positions available for hire. All applicants will apply through this requisition and if selected will be hired into one of the available positions.

Job Qualifications

We're seeking a flexible, customer-focused, detail-oriented individual with:

• Minimum two years in medical registration, billing, insurance processing or financial counseling required, preferably in a healthcare ambulatory department setting.
• In-depth knowledge of insurance plans (e.g., CPT, ICD-1, HMO, PPO, Medicare, Medicaid/MediCal, Workman's Compensation, etc.)
• Demonstrated knowledge of insurance authorization and verification process
• Skill in analyzing information, problems, situations, practices, and procedures; identify patterns and tendencies, formulate logical and objective conclusions, and recognize alternatives and their implications
• Ability to read and interpret documents such as training manuals, patient care referrals, authorizations, payor contracts, coverage to determine financial responsibility, benefits, and one-time agreements
• Ability to write routine reports and correspondence. Ability to effectively present information in one-on-one and small group situations to supervisors, patients, patient's family and other employees of organization.
• Ability to accept and carry out oral instructions accurately and work independently as well as a part of a team within a demanding environment
• Ability to prioritize work, handle multiple tasks to completion and make decisions on which course to follow for a particular situation
• Skill in speaking clearly and distinctly using appropriate vocabulary and grammar; telephone manners to handle heavy phone work with courtesy and tact
• Ability to work independently and follow through on assignments with minimal direction and supervision
• Ability to adapt and implement frequently changing procedures
• Knowledge of medical terminology and the ability to distinguish different exams and medical diagnoses
• Knowledge and familiarity with the Department and Hospital computer systems, including pre-registration and insurance verification procedures in the appropriate computer system