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 .
PAS Resource Specialist
US-OR-Portland
Job ID: 2025-34006 Type: Regular Full-Time # of Openings: 1 Category: Hospital/Clinic Support Portland, OR (Waterfront)
Overview
Managed Care & Billing:
Obtains all authorizations, including retroactive authorizations, contacting primary care physicians or their designees to obtain authorizations for care as required. The authorization process includes, but is not limited to, putting the referrals information on-line, tracking the number of visits used per authorization, following up on referrals for return appointments and other miscellaneous tasks.
Gathers and/or verifies patient information including demographics, insurance coverage, and financial status. Educates patients , face-to-face when necessary, on related billing issues as appropriate; quoting self-pay or deposits where indicated. Obtains authorizations for clinical care, procedures, and laboratory studies. Follows up on pending authorizations until they are obtained. Works closely with Faculty and staff to ensure authorizations/referrals in place prior to any appointments, diagnostics or procedures involving managed care patients. Manage billing work queues as assigned which may include back-up for follow-up work queues. Serves as a resource for insurance and billing questions for patients, staff and referring physicians. Maintains current information on all managed care insurance plans and is up to date with all managed care insurance plan changes, utilizing information to efficiently and effectively obtain authorizations. Strong knowledge of OHSU insurance contracts with medical and vision carriers and the ability to explain the billing differences to patients, staff and referring physicians. Answers insurance questions for all patients, scheduled or non-scheduled, directing patients to appropriate provider for other health care issues. Attend managed care coordinator meetings at OHSU and billing meetings at Casey Eye Institute to maintain billing knowledge and obtain new information.
Other duties may include back-up phones, scheduling, check in/out, cash handling, and other duties as assigned by supervisor.
Enters all information accurately into OHSU databases or into the medical record when necessary.
Responsibilities
One year of experience in a medical office setting, including high-volume direct patient contact, scheduling of appointments and obtaining managed care authorizations. 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. Proficient in university network computer applications using Windows, PowerPoint, Cadence, EPIC and related applications. Working knowledge of medical terminology. Strong relationship building skills with patients, health plans, providers, staff, management. Exceptional customer service skills - both in person and on the phone. Patient advocacy skills - evaluate patient concerns for timely resolution. Sensitivity to patient needs. Demonstrated evidence of strong written and verbal communication skills. Ability to manage competing priorities. Ability to meet deadlines and urgent patient and system needs. Ability to work independently; willingness to serve as a positive and professional role model.
