Clinical Operations Analyst

Under the direction of the Administrative Services Director, the Clinical Operations Analyst provides comprehensive services in within the areas of Billing, Insurance, Purchasing, and Referrals to support the clinical service delivery at CAPS. Primary duties include: dissemination of information regarding the benefits and processes of the multi- million dollar Student Health Insurance Plan (SHIP) and its relation to the University of California health insurance requirements, including providing 1:1 insurance consultation meetings with students; providing direction and assisting with complex claims determinations, corrections and resolutions; assisting CAPS clinical staff, outside professional providers, and the UC SHIP Insurance office in case management and linkage to appropriate mental health resources and services; production and presentation of campus wide SHIP mental health insurance orientations to students, parents, potential professional students and university staff through orientation and outreach; serving as the primary point of contact for CAPS retroactive referral renewals and referral-related issues; authorization and filing of CAPS mental health claims processing for UCLA students enrolled in UC-SHIP, including analysis and resolution of denied claims; processing, follow up, and preparation of CAPS departmental purchasing including but not limited to ongoing contracted vendor accounts and day to day operational materiel needs . Participates as the insurance liaison to the CAPS clinical teams and serves as a member of the CAPS Support Staff.

Percentage of Time:
100

Shift Start:
8:00 am

Shift End:
5:00 pm

Qualifications for Position

13
Records

Qualifications

Required/Preferred

Skill in verbal and written communication to address complex medical insurance issues with individuals from various ethnic, cultural, socio-economic levels.

Required

Working knowledge of the health insurance industry standards, practices, regulations, and State and Federal Mandates.

Required

Skill in perceptive and active listening to accurately interpret issues and medical insurance problems that are presented by patients and professional staff/contacts.

Required

Ability to trouble-shoot and problem-solve complex medical insurance issues, ranging from enrolling, waiving and canceling, to referral, coverage, and claim payment issues that are presented by patients and professional staff/contacts.

Required

Working knowledge of medical and insurance terminology.

Required

Skill and ability to perform good customer service with patience and compassion.

Required

Skill and ability to work as a team member of the insurance office and as part of the entire Ashe Center organization.

Required

Skill in setting priorities which accurately reflect relative importance of job responsibilities.

Required

Ability to compose, edit, and type written communication in a professional and clear format.

Required

Skill and ability to work with current computer technology including current Office and Word programs, PowerPoint, University BAR system, Ashe Center computer programs

Preferred

Ability to maintain confidentiality and sensitivity with regard to patient medical conditions and medical records in accordance with HIPAA and Privacy practices under Federal Law.

Required

Ability to interact effectively with a diverse population which includes students, staff, administrators and parents from various backgrounds including ethnic, cultural, socio-economic, religious, sexual and political orientations.

Required

Working knowledge of the insurance claim process and understanding of diagnostic coding, ICD9, professional CPT coding and facility revenue codes.

Required

Additional Posting Information

Bargaining Unit:
99-Policy Covered

Application Deadline:
08-26-2022

External Posting Date: