Principal Access Representative

Job SummaryThe incumbent for this position is primarily responsible for the analyzing of records, to include bone marrow transplant, donor, and recipient methodologies for the purposes of verifying eligibility, processing referrals, submitting authorizations, and following up on complex bone marrow transplant cases. This is a resource to the Cancer Center Bone Marrow Transplant Authorization Coordinators, Billing, Coding, Accounts Receivable, Financial Clearance Departments, and other key UC Davis revenue cycle departments. This position requires the skills and ability to manage the level of responsibility and accountability necessary to provide guidance for the department/clinical team for which it is assigned. This position must serve as a subject matter expert and resource person for a small group of MOSC 1, MOSC 2, MOSC 3, and/or other complex service lines. This position is responsible to act as a liaison with insurance companies, contract office, and in-patient and out-patient areas associated with care delivery for the transplant or clinical trial process for the adult population. Works with contract office if individual contracts are needed. Keep appropriate records that are involved in the authorization approval or denial processes. Works directly with patients when needed to explain and guide them through the process. Assists with denials taskforce for prevention of claim denials related to authorization. Responsible to maintain and manage a high-volume in-patient and out-patient referrals.Apply By Date 5/19/2026 by 11:59pmMinimum Qualifications - For full consideration, applicants are encouraged to upload license and/or certification if required of the positionHigh School Diploma, GED or equivalent experience. Two (2) years of experience coding and/or obtaining authorizations for Bone Marrow Transplant, Clinical Trial, or Oncology related services.Knowledge of ICD-10 and HCPS coding sufficiently to identify services performed, including diagnosis, procedures, and supplies.Knowledge of practices and protocols related to medical office procedures, (i.e., medical terminology, appointments, medical records, insurance verification, cashiering, billing, etc.).Knowledge of health care insurance systems, which may include Medi-Cal, MediCare, HMO, PPO, fee-for-service, county funded coverage, and workers compensation, sufficient to properly obtain and track authorizations, appoint patients, make referrals for consults, diagnostics and ancillary services, coordinate hospital services, complete and submit billing documentation, and explain provisions and requirements to patients.Demonstrates leadership skills that reflect the ability to serve as the coordinator of the specified unit of workers and must be able to represent the team and be a subject matter expert and resource person for staff.Ability to accomplish a variety of concurrent assignments in an effective and efficient manner, demonstrating ability to organize, prioritize and complete assignments in a designated timeframe. Ability to adjust to changing workload or assignments and pressures of increased workloads or deadlines. Ability to work independently, prioritize and meet deadlines.Problem solving skills to independently define a problem identify the resources available to help solve the problem, create viable solutions, and take the necessary action to implement problem resolution and ensure prompt and satisfactory resolution. Ability to accomplish or complete a task to demonstrate in detail all areas involved.Decision making skills to independently exercise delegated authority to take action and to appropriately see assistance from others when limits of delegated authority have been reached.Interpersonal skills to establish and maintain effective working relationships with all co-workers; to consistently interact with patients and other members of the public with patients, courtesy, and professionalism, both in person on the telephone; and to effectively respond to individuals who may be angry or upset.Ability to efficiently use computer system applications for al functions required for this position, including electronic email, spreadsheets, word processing, and medical office management.Typing skills sufficient to computer keyboard for timely and accurate input and production.Writing skills, using proper English grammar, spelling, and punctuation, sufficient to compose messages and/or routine correspondence, which is clear, concise, and easy to understand.Organizing skills to establish priorities for own work within stated guidelines; respond flexibility to changes in priorities; and maintain work effectiveness in a setting with a high volume of patient activity and frequent interruptions.Filing skills to maintain logs and files of information in alphabetical, chronological and/or numerical order, such that is current and easily retrievable. Knowledge of all pertinent laws, regulations, and guidelines governing medical records; confidentiality, privacy, and provision to others, including HIPAA.Preferred QualificationsCoding Certification (CPC or CPC-A) Any BMT related or Clinical Trial Certification EPIC experience EMR experience Coding and Billing experience Authorization and Referrals experience Demonstrated knowledge of medical terminology Key Responsibilities50% - Bone Marrow Transplant Authorizations50% - Bone Marrow Transplant Billing and Denial ManagementDepartment OverviewUC Davis Comprehensive Cancer Center offers comprehensive stem cell transplant services. Our expert team of doctors, nurses, and specialist's guides patients and donors through the process. We provide state-of-the-art facilities for stem cell collection, storage, and safe transplantation within a dedicated Bone Marrow Transplant Unit.Department Specific Job ScopeThis position in involved in the management and administration of new patient referrals, patient registration, pre-admissions for transplant services, scheduling, insurance eligibility and authorization and referral for services. Services are provided within the Cancer Center and Inpatient Hospital. Functions are provided in concert with clinical and business departments across the organization, to ensure efficient patient flow and to maximize revenue collection. Works closely with revenue cycle, patient financial services, and other ambulatory departments to maintain payer requirements, denial prevention, and continuous process improvement.POSITION INFORMATIONSalary or Pay Range: $31.24 - $38.82Salary Frequency: HourlySalary Grade: 235UC Job Title: ACCESS REPR PRNUC Job Code: 009099Number of Positions: 1 Appointment Type: Staff: CareerPercentage of Time: 100Shift (Work Schedule): 8am-5pmLocation: Armstrong Building (OTH167)Union Representation: EX-Patient Care TechnicalBenefits Eligible: YesThis position is 100% on-siteBenefitsOutstanding benefits and perks are among the many rewards of working for the University of California. UC Davis offers a full range of benefits, resources and programs to help you bring your best self to work, as well as to help you and your family achieve your health, wellness, financial and career goals. Learn more about the benefits below and eligibility rules by visiting either our handy Benefits Summary for UC Davis Health Employees or Benefits Summary for UC Davis Employees and our Benefits Page.If you are represented by a union, benefits are negotiated between the University of California (UC) and your union and finalized in a contract. Read your bargaining unit's employment contract, stay abreast of current negotiations and learn about collective bargaining at UC: https://ucnet.universityofcalifornia.edu/labor/bargaining-units/index.htmlHigh quality and low-cost medical plans to choose from to fit your family's needsUC pays for Dental and Vision insurance premiums for you and your familyExtensive leave benefits including Pregnancy and Parental Leave, Family & Medical LeavePaid Holidays annually as stipulated in the UC Davis Health Policies or Collective Bargaining AgreementPaid Time Off/Vacation/Sick Time as stipulated in the UC Davis Health Policies or Collective Bargaining AgreementContinuing Education (CE) allowance and Education Reimbursement Program as stipulated in the UC Davis Health Policies or Collective Bargaining AgreementAccess to free professional development courses and learning opportunities for personal and professional growthWorkLife and Wellness programs and resourcesOn-site Employee Assistance Program including access to free mental health servicesSupplemental insurance offered including additional life, short/long term disability, pet insurance and legal coveragePublic Service Loan Forgiveness (PSFL) Qualified Employer & Student Loan Repayment Assistance Program for qualified rolesRetirement benefit options for eligible roles including Pension and other Retirement Saving Plans. More information on our retirement benefits can be found herePhysical DemandsStanding - Occasional Up to 3 Hours Walking - Occasional Up to 3 Hours Sitting - Frequent 3 to 6 Hours Lifting/Carrying 0-25 Lbs - Occasional Up to 3 Hours Pushing/Pulling 0-25 Lbs - Occasional Up to 3 Hours Bending/Stooping - Occasional Up to 3 Hours Squatting/Kneeling - Occasional Up to 3 Hours Twisting - Occasional Up to 3 Hours Reaching overhead - Occasional Up to 3 Hours Keyboard use/repetitive motion - Frequent 3 to 6 Hours Mental DemandsSustained attention and concentration - Frequent 3 to 6 Hours Complex problem solving/reasoning - Occasional Up to 3 Hours Ability to organize & prioritize - Frequent 3 to 6 Hours Communication skills - Frequent 3 to 6 Hours Numerical skills - Occasional Up to 3 Hours Constant Interaction - Frequent 3 to 6 Hours Customer/Patient Contact - Frequent 3 to 6 Hours Multiple Concurrent Tasks - Frequent 3 to 6 Hours Work EnvironmentUC Davis is a smoke and tobacco free campus effective January 1, 2014. Smoking, the use of smokeless tobacco products, and the use of unregulated nicotine products (e-cigarettes) will be strictly prohibited on any UC Davis owned or leased property, indoors and outdoors, including parking lots and residential space.Special Requirements – Please contact your recruiter with questions regarding which activities apply by positionThis is a critical position, as defined by UC Policy and local procedures, and as such, employment is contingent upon clearing a criminal background check(s) and may include drug screening, medical evaluation clearance and functional capacity assessment This position is designated as a mandated reporter under CANRA and UC policy, and employment is contingent on compliance with applicable policies, procedures and training requirementsMisconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.A Culture of Opportunity and BelongingAt UC Davis, we’re committed to solving life’s most urgent challenges and building a healthier, more resilient world. We believe in growing through every challenge, continually striving to improve, and welcoming new perspectives that strengthen our community. We recognize that a vibrant and innovative organization values both individual strengths and shared purpose. The best ideas often emerge when people with different experiences come together.As you consider joining UC Davis, we invite you to explore our Principles of Community, our Clinical Strategic Plan and strategic vision for research and education. We believe you belong here. The University of California, Davis is an Equal 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.To view the University of California’s Anti-Discrimination Policy, please visit: https://policy.ucop.edu/doc/1001004/Anti-DiscriminationBecause we want you to feel seen and valued, our recruitment process at UC Davis supports openness and authenticity. Research shows that some individuals hesitate to apply unless they meet every qualification. You may be an excellent fit for this role-or the next one. We encourage you to apply even if your experience doesn't match every listed requirement. #YouBelongHereTo learn more about our background check program, please visit: https://hr.ucdavis.edu/departments/recruitment/ucd/selection/background-checks