Job Description: Oregon Health & Science University
Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.
PAS Resource Specialist
US-OR-Portland
Job ID: 2024-32361 Type: Regular Full-Time # of Openings: 1 Category: Hospital/Clinic Support Portland, OR (Marquam Hill)
Overview
Customer Service: Provides high quality customer service to both external customers (patients and their families, referring providers, and insurance carriers) and internal customers (OHSU health care providers and staff) that meets or exceeds the service standards of the health care industry. This duty includes prompt and professional communication efforts, face-to-face customer contact skills, crisis management, facility with available information technology, standard complaint processing, flexible coverage of internal service needs, and the continuous application of process improvement methods and skills.
Surgery Scheduling: Schedule surgeries for the Adult Cardiothoracic Surgery Services. Obtain all required authorizations and referrals necessary for surgical procedures. Review cpt/dx codes to determine if below or above the line compliance. Place referrals in EARL. Schedule any pre-surgical testing and coordinate any preop needs with patients and surgeons prior to surgical date and document in EPIC. Prepare and mail patient surgery packets. Advise patient of what to expect for check in times and set expectation for possible delays. Send out weekly surgery schedule to physician and team. Keep surgery schedule send out list up to date. Make surgery reminder calls day before surgery.
Managed Care: Follow up on referrals for future appointments within 2-business days. Attend monthly managed care meetings and share information with staff. Serve as liaison and information resource for physicians, nursing support, coworkers, referring physicians, etc. on insurance authorization requirements. Review CPT and diagnosis codes to determine if below or above the line compliance and utilize Division Access Management policies as applicable. Determine appropriate TOS payment amounts (including co-pays, co-insurance, deductibles, deposits, prepayments, etc.) and arrange for their collection at the time of service and document in EPIC. Arrange for T&C forms, NCSF, etc. and submit as appropriate. Apply problem solving skills and negotiation skills in resolving patient concerns and managed care related problems. Follow up on UMG denials as requested by manager. Perform other miscellaneous tasks relating to the managed care processes at OHSU.
Telecommunications: Triage incoming calls and route callers to appropriate provider, staff or resource; accurately document and relay any messages using EPIC telephone/refill encounter as appropriate; direct calls of complaint, requests for information, urgent health care concerns and general inquiries to the appropriate source.
Responsibilities
One year of experience in a medical office setting, including high-volume direct patient contact, scheduling of appointments and may require experience obtaining managed care authorizations (dependent on position description). OR one and a half years of work experience in a high volume direct public contact position and 6 months experience in a medical office setting. The candidate must have a thorough knowledge of PAS policies and procedures. Candidates will have demonstrated advanced PAS user skills as well as extensive knowledge of integrated care at OHSU.
Basic computer skills including word processing. Windows applications, on-line scheduling, and a preference for data-base skills. Excellent verbal and written communications skills. Strong customer service orientation. Demonstrated effectiveness in confrontational customer interactions.
Qualifications
HS Diploma or advanced degree preferred.
Experience in a medical and/or oncology office setting.
Knowledge of Epic, OHSU network systems, including Outlook and Microsoft Office products.
