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The IRD for this job is: 11-13-2023
ABOUT UC SANTA CRUZ
UC Santa Cruz is a public university like no other in California, combining the experience of a small, liberal arts college with the depth and rigor of a major research university. It's known as an unconventional place where innovation and experimentation is part of the campus's DNA. That playful, bold spirit still thrives today, all on a campus renowned as among the most beautiful in the world.
Risk and Safety Services is comprised of five departments and each of these units is dedicated to maintaining and promoting an aspect of the health and safety of all members of the campus community. Risk and Safety Services provides leadership and coordinates multidisciplinary services to sustain a safe and healthy campus by managing risk, preventing injury and loss, and coordinating access, emergency response, and recovery. Risk Services is a department within Risk and Safety Services, which supports the campus by helping departments identify their risk exposures, recommending strategies to reduce or eliminate identified risks, and administering the campus insurance programs to facilitate maximum recovery from accidental losses. Risk Services encourages and supports a safe, healthy and thriving campus community.
Under the general supervision of the Interim Director Risk Services/Director Occupational Health, the Occupational Health Analyst uses skills as an experienced professional with a full understanding of industry best practices and procedures. The Occupational Health Analyst performs a wide variety of functions in the following areas: registration, appointment scheduling, insurance and billing, and report coordination. The position of Occupational Health Analyst supports a wide range of front office areas and is responsible for the occupational risk report programs.
Budgeted Salary: $80,300 - $85,900/Annually. Salary commensurate with skills, qualifications and experience. Under California law, the University of California, Santa Cruz is required to post a reasonable estimate of the compensation for this role. The salary shown above is the budgeted amount the University reasonably expects to pay and the salary extended should not exceed this posted amount.
Manages Electronic Health Record software program. Manages the software updates regarding the Electronic Health Record as applicable.
Administers highly complex claims billing and monitors payments in employee injury and medical surveillance insurance programs regarding third-party administrators and departments as applicable.
Prepares third-party billing per industry best practices and the Official Medical Fee Schedule.
Implements and monitors control strategies and programs involving claim payments. Manages billing process to coordinate with occupational health reports to the third-party claims administrator.
Liaises with third parties to promptly resolve payment of claims, per organization guidelines,.
Provides primary reception and service-oriented receiving of customers; directs incoming clients to the appropriate departments; registers and checks in employees for scheduled appointments.
Provides primary scheduling of medical appointments for employees, manages phone and walk-in appointments; manages rescheduling of appointments as applicable.
Works directly with and serves as a resource for the interpretation of insurance and billing policies and procedures for applicable program department staff.
Follows procedures needed to administer the occupational health programs by confirming eligibility for coverage; advising staff of policy and procedure when receiving clinical referrals to receive health care off campus; assists as liaison between the clinician, staff, outside health care provider, and claims processor; as well as explanation of procedures and staff resources.
Manages scheduled occupational health program timelines in coordination with department and campus stakeholders.
Obtains authorization from outside and internal providers for specialist referrals to facilitate care.
Tracks referrals to ensure quality management and facilitates completion of services.
Ensures services are coded accurately; and for billing external claims insurance providers or for applicable occupational health services; manages insurance balances.
Manages accompanying billing correspondence for claims examiners; work status and progress reports.
Documents account status updates, transactions, decisions, and other actions for facility revenue billing and payment activities in the electronic health record system.
Administers and coordinates occupational health referrals and service authorization processes.
50% - Risk Management
Develops, implements, and administers risk management self-insured programs and operations concerning insurance claims administration, and loss prevention.
Gathers, analyzes, prepares, and summarizes areas of potential loss. Develops trend reports to assist in mitigating future loss.
Performs complex accounting and risk finance related to the monitoring of risk control strategies and programs. Develops corresponding reporting to identify safety trends.
Participates in annual updates and periodic review committees for occupational health programming.
Conducts trend analysis reports.
Coordinates with organizational units to obtain applicable reports for third-party claims administrator billing.
Designs, develops, and presents training presentations to internal departments and programs regarding occupational regulatory updates.
Bachelor's degree in related area and/or equivalent experience/training.
Knowledge in the following areas: risk management; insurance; analysis; accounting; knowledge of common computer application programs; knowledge of organizational processes and procedures; understanding or organization rules and regulations.
Knowledge of medical terminology, medical records management, and experience using electronic health record systems and data bases.
Knowledge of occupational health programs, e.g. workers' compensation, Official Medical Fee Schedule.
Experience working in a healthcare office, working knowledge of billing software.
Proven interpersonal skills and active listening skills, and customer service orientation.
Proven organizational skills.
Proven ability to utilize tact, discretion and confidentiality in all communications, including with staff and outside medical services.
Proven ability to use critical thinking and analytical skills to solve problems.
Strong skills required to develop course materials and deliver content effectively to diverse populations.
Ability to concisely present complex risk findings and make recommendations verbally and in writing.
SPECIAL CONDITIONS OF EMPLOYMENT
Selected candidate will be required to pass a pre-employment criminal history background check.
Must possess CPR/First Aid/AED certification or have the ability to obtain it within 60-calendar days of hire.
Must possess a valid license to drive in the state of California.
Ability to work long periods of time at a computer with or without accommodation.
The selected candidate will be required to work primarily on campus, with periods of remote work possible based on operational needs. If a hybrid work schedule is confirmed, the selected candidate must be able to work successfully from a home/remote office and be able to fulfill the requirements of the UCSC telecommuting agreement.
Selected candidate will be required to complete training within established time frames as directed including UC compliance training.
Clery Act: This position has been identified as a Campus Security Authority (CSA); required to report crimes, incidents, and disciplinary referral statistics as required by the Jeanne Clery
Disclosure of Campus Security Policy and Campus Crime Statistics Act (20 USC 1092(f)).
Ability to maintain appearance and conduct suitable for working in a professional setting.
The University of California has implemented a Vaccination Policy covering all employees. Employees, including new hires, are required to comply with any applicable policies relating to the University of California vaccine program.
Per the Child Abuse and Neglect Reporting Act (CANRA), this position has been identified as a Mandated Reporter. The selected candidate will be required to report known or suspected child abuse or neglect as defined by CANRA and will be required to sign a Statement Acknowledging Requirement to Report Child Abuse prior to commencing employment. CANRA Penal Codes, and related definitions, requirements, and responsibilities may be obtainedhere.
All UCSC employees must understand and follow job safety procedures, attend required health and safety training, proactively promote safety at work, and promptly report actual and potential accidents and injuries.
The University of California is an Equal Employment Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, or protected veteran status. UC Santa Cruz is committed to excellence through diversity and strives to establish a climate that welcomes, celebrates, and promotes respect for the contributions of all students and employees.
To ensure review of application materials by the hiring unit, they must be submitted on or before the initial review date (IRD) via the Staff Employment Opportunities web site; https://jobs.ucsc.edu. A computer is available at the UC Santa Cruz Staff Human Resources Office located at Scotts Valley Center. The Scotts Valley Center is located at 100 Enterprise Way, Suite E100, Scotts Valley, CA 95066. To learn more or to request disability accommodations, call 831-459-2009. Hearing impaired are encouraged to use the California Relay Service at 800-735-2922. UC Santa Cruz is an Equal Opportunity Employer.
The University of California is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, or protected veteran status. UC Santa Cruz is committed to excellence through diversity and strives to establish a climate that welcomes, celebrates, and promotes respect for the contributions of all students and employees.
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