Quality Commission Trainer - Financial Clearance Unit

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
• Ensure 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
• Support department training efforts for new staff members, maintain training materials, identify and fill training gaps to ensure high quality work, and provide 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
• Assist with training desk staff on CareConnect (Missing Registration and Insurance Verification) work flow process and other applicable needs
• Excellent customer service is provided to patients, faculty/staff, including outside vendors, insurance company representatives and registration representatives

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