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Insurance Advocate Location: Job ID: 83102 JOB POSTING UC Santa Cruz Student Health Services is excited to announce a new opportunity for an Insurance Advocate. We're looking for a detail oriented, student focused professional to support insurance navigation at the UCSC Student Health Center. In this role, you will assist students with insurance questions, verify eligibility and coverage, coordinate referrals and authorizations, manage data across multiple systems, and partner with internal departments and external providers to ensure timely, accurate support. UC Santa Cruz UCSC) is the county's largest employer and one of the most beautiful campuses in the nation. Perched on the coast overlooking Monterey Bay, our main campus offers a stunning setting and a vibrant community where over 3,100 staff members build meaningful careers, enjoy comprehensive benefits, and contribute to a mission that makes a difference. UCSC offers staff a comprehensive benefits package designed to support health and well-being. Here is a sample of benefit options: Medical, dental, and vision insurance plans UC Retirement Pension Plan Optional life, legal, and pet insurance Paid holidays, plus accrued vacation and sick leave Discounts at UCSC recreation facilities For details, please visit: UCnet-Benefits Thank you for your interest in joining the UC Santa Cruz community. HOW TO APPLY For full consideration, applicants should attach their resume and cover letter when applying for a job opening. For guidance related to the application process or if you are experiencing difficulties when applying, please review the Applicant Resources on our website. How to Apply Troubleshooting Tips for Applicants FAQ's INITIAL REVIEW DATE (IRD) UC Santa Cruz jobs are posted until filled. All application materials submitted by 11:59 pm on the IRD will be routed to the hiring team for consideration. NOTE: Applicants who miss the IRD are still encouraged to apply; their materials will still be forwarded for consideration if requested by the hiring team. Application materials cannot be accepted outside of the jobs portal. Applications cannot be edited on an applicant's behalf. For more information about the IRD and the applicant review process, view this link. The IRD for this job is: 01/21/2026 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. DEPARTMENT OVERVIEW UC Santa Cruz (UCSC) Student Health Services (SHS) is a full-service medical facility offering clinical, educational, and psychological support to UCSC students. SHS is deeply committed to ensuring affordable, well-integrated, multidisciplinary healthcare that effectively supports the university's diverse campus communities through equitable access and culturally competent, high-quality programs and services. The Primary Care Program offers primary care and same-day care services, supported by on-site radiology, a COLA-accredited clinical laboratory, and the campus pharmacy offering prescription and over-the-counter products. Counseling and Psychological Services, Case Management and Psychiatry services are available for crisis intervention, mental health support, and outreach services. Additional departments include Student Health Outreach and Promotion (SHOP), home of the Condom Co-op, the Cove Collegiate Recovery Program (CCRP), where students receive harm-reduction and recovery services; CARE (Center for Advocacy, Resources & Empowerment) the advocacy and prevention education office that supports those who have experienced sexual assault, stalking, and dating/domestic violence; Optometry, and Student Insurance and Referral Programs. Student Health Services employs approximately 150 staff and welcomes staff with an interest and experience working with college students with a wide range of ethnic, cultural, and gender identities. More information can be found at healthcenter.ucsc.edu JOB SUMMARY Under the direct supervision of the Assistant Director of Clinic Support, Billing, & Insurance performs a wide variety of tasks in the following areas: insurance claims, insurance authorizations, data entry, front desk, and administrative support. APPOINTMENT INFORMATION Budgeted Salary:$29.38/hourly 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. Benefits Level Eligibility: Full benefits Schedule Information: Full-time, Fixed Percentage of Time: 100%, 40 Hours per Week Days of the Week: Mon-Fri Shift Includes: Day Employee Classification: Career appointment Job End Date: None Work Location: UC Santa Cruz Main Campus Union Representation: Clerical Employees (CX) Job Code Classification: BLANK AST 3 (004722) Travel: Never or Rarely JOB DUTIES 40% - Insurance Navigation and Student Support Assists students and staff with UC SHIP, CruzCare, and private insurance inquiries. Provides guidance on insurance policies, billing procedures, and benefit navigation. Educates students on referral processes and supports navigation of complex insurance requirements. Provides follow-up with students via email and secure messaging via EMR. Documents patient encounters and related communications. Provides vision benefit information and schedules Optometry appointments. 25% - Eligibility, Coverage Verification and Referrals Verifies eligibility and confirms insurance coverage. Tracks referrals and retro-referrals to support timely follow-up and quality monitoring. Obtains prior authorizations for advanced imaging by reviewing chart notes and submitting required clinical information. Communicates with UC SHIP and carrier representatives regarding coverage, benefits, and services. 20% - Administrative Duties and Data Management Processes quarterly UC SHIP waiver requests. Maintains insurance data in FileMaker and updates student account information in AIS. Processes Health Fund financial support applications. Coordinates and authorizes approved Uber Health ride requests. 15% - Interdepartmental & External Coordination Coordinates with internal UCSC units (Registrar, SBS, Cashiers, Graduate Division, Financial Aid) and external providers, facilities, and claims processors. Participates in annual plan review and process improvement efforts by contributing feedback on plan performance. REQUIRED QUALIFICATIONS High school diploma or equivalent experience One year experience in a medical office or healthcare administrative setting Knowledge of medical office procedures and medical records workflows Experience using medical terminology and strong understanding of healthcare delivery Experience with electronic medical records, scheduling, and data entry Experience working across multiple information systems and validating data accuracy Ability to explain complex information clearly in writing and verbally to diverse populations Ability to research and resolve complex administrative problems Strong organization and attention to detail; able to proofread for accuracy Ability to prioritize multiple tasks with frequent interruptions Demonstrated customer service and active listening skills Ability to handle confidential and sensitive situations with tact and professionalism Ability to work effectively with clinical staff, supervisors, external providers, patients, and families Awareness and respect for cultural and lifestyle diversity PREFERRED QUALIFICATIONS One year of clerical experience in a medical healthcare environment with demonstrated proficiency in navigating electronic medical record platforms, coordinating and resolving insurance claim issues, obtaining clinical service authorizations, and managing high-volume, multi-line phone systems SPECIAL CONDITIONS OF EMPLOYMENT Selected candidate will be required to pass a pre-employment criminal history background check. Selected candidate must pass the employment misconduct disclosure process. The selected candidate will be required to work all scheduled hours on-site. Selected candidate will be required to take a TB test within 60 days of hire. Selected candidate will be required to complete training within established time frames as directed including UC compliance training. Complete Health Insurance Portability and Accessibility (HIPAA) training within 30 days of hire. Will be required to comply with current Student Health Center employee health safety requirements for health care workers as defined by state and federal regulatory agencies. Current health safety requirements are discussed during interview. Ability to maintain appearance and conduct suitable for working in a professional setting. Selected candidate will be required to complete training within established time frames as directed including UC compliance training. 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 . click apply for full job details

PURPOSE AND SCOPE: Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory requirements and programs. Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of care and patient and staff safety PRINCIPAL DUTIES AND RESPONSIBILITIES: Manages the tactical execution of short- and long-term objectives through the coordination of activities with a direct responsibility for results, including costs, methods, and staffing. Provides leadership, coaching and development plans for all direct reports to maintain an engaged and productive workforce; partnering with Human Resources on employee matters. Technically proficient in the specific department and knowledge of industry practice and business principles. Works on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends. Has a larger range within the department. Responsible for supporting and driving FMS quality standards through meeting all ESRD regulatory requirements and the practice of Quality Assessment and Improvement (QAI), including use of FMS QAI tools. Responsible for addressing and acting on adverse events and action thresholds. Oversees facility's Home Therapies Program if applicable. Accountable for compliance with all applicable federal, state and local laws and regulations. Ensures all FMS Clinical Quality policies and procedures are communicated to and implemented by the facility staff. Maintains integrity of medical records and other FMS administrative and operational records. Complies with all data collections and auditing activities. Maintains facility environmental integrity, including safety. Experienced leadership required for multi-faceted environment; role primarily focuses on tactical execution. Receives assignments in the form of objectives and determines how to use resources to meet schedules and goals. An individual contributor will have significant project/process responsibilities. Program or project responsibility generally within the function. Follows processes and operational policies in selecting methods and techniques for obtaining solutions. Interprets and recommends change to policies and establishes procedures that effect immediate organization(s). Decisions have an impact on work processes and outcomes. Erroneous decisions or failure to achieve results will add costs and may impact the short-term goals of the organization. Frequently interacts with subordinate supervisors, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers. Participates and presents at meetings with internal and external representatives. Often leading a cooperative effort among members of a project team. Interacts with internal departments and external customers; particularly in problem resolution. Acts as an advisor to subordinate(s) to meet schedules and/or resolve technical problems. Responsible for hiring, coaching and counseling employees, including performance reviews, disciplinary action and terminations. Provides technical guidance. Performs other related duties as assigned. PATIENT CARE: Coordinates all aspects of patient care with the appropriate staff members, from admission through discharge of the patient. Ensure education of the patient regarding quality measures, transplant options, modality awareness, and access care, including catheter reduction and adherence to treatment regime. Acts as a resource for the patient to address patient concerns and questions. Accountable for timely completion of patient care assessments and care plans by organizing meetings of the facility's Interdisciplinary Team to discuss patient care plans and to resolve patient problems. Directs initiation, maintenance and communication of efficient and timely patient schedules to ensure maximization of the facility station efficiency. Is aware of and develops a mechanism or process for knowing the specific situation of each patient, including hospitalizations, no- shows, catheter use, and any significant change in patient care status. Develops action plans for unexcused and missed treatments in collaboration with the Director. Plans, coordinates and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely workup of patients for access management, dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination of care with the multidisciplinary renal team. Communicates changes in patient status regarding clinical, insurance, travel and transportation issues to the disease management company. Maintains current knowledge of disease management software and systems as pertinent. STAFF: Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. Participates in the recruitment and interview process, and decision to hire new personnel. Ensures completion of new hiring orientation and training including mandatory in-services and ICD code training when applicable. Ensures documentation completed for annual in service training, and policy and procedure in service updates. Responsible for all patient care employees receiving appropriate training according to FMS policy, including training to ensure ongoing compliance with all FMS risk management initiatives. Provides opportunities for professional growth, and training to ensure clinical competence and the ability for licensed staff to assume Team Leader responsibilities Responsible for overseeing performance of all licensed personnel, direct patient care staff, reporting indirect patient care personnel as assigned, and when necessary, technical staff. Provides employee education and guidance, and feedback related to performance. Maintains current knowledge regarding FMCNA benefits, Human Resources policies, procedures, and processes, and acts as a resource to facility staff. Provides counseling for all clinical staff members at regular intervals offering support and encouraging professional growth. Completes timely employee evaluations and establishes annual goals for staff. Provides written documentation of all disciplinary conferences in accordance with the established personnel policies, and confers with the Director and Human Resources regarding the nature of the disciplinary decisions. Participates in Corporate and Business Unit specific employee recognition and satisfaction programs. Creates, maintains, and communicates efficient and timely employee schedules according to the needs of the facility. Creates and implements a Continuous Quality Improvement (CQI) Process Improvement Team that involves staff in problem solving. PHYSICIANS: Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. Responsible for strong Director and physician relationships and facilitating staff relationships with physicians. Ensures regular and effective communication with all physicians, through regular meetings with Directors. Participates in Governing Body. Schedules and coordinates CQI meetings with physicians. MAINTENANCE/TECHNICAL: Responsible for the integrity and safety of the facility water system. Must be knowledgeable in the operation of all facility equipment and technology. ADMINISTRATIVE: Responsible for maintaining and updating all FMS manuals. Accountable for completion of the Annual Standing Order Review and ICD coding. Checks correspondence whether electronic, paper or voice mail, and responds as appropriate. Directs information gathering as required supporting billing and collection activities. Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve supply cost goals following all guidelines established in FMS formularies Participates in the completion and interpretation of the Pl-17 inventory supply use analysis. Reviews and approves facility payroll. Reviews profit and loss statements with Director Responsible for participating in all required Network reporting and on-site state or federal surveys. Participates in the completion of the FMS Administrative Clinical Review. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. . click apply for full job details