PAS Revenue Cycle Specialist at Oregon Health… · Portland

Department Overview

The Centralized Check-In department is responsible for signing-in/admitting patients for their procedures and/or appointments at the Center for Health and Healing, Beaverton and Orenco campuses, as well as any new locations identified across OHSU Health in the future. If the patient has multiple procedures/appointments for that day, on a given campus, the Centralized Check-In process will allow the department to check-in/admit the patient for all care at one time.

The Centralized Check-In department is also responsible for kicking off patients, event tracking, and signaling so that all care teams within the campus know where the patient is at in their care. Prior to signing-in/admitting a patient, the Centralized Check-In department is responsible for helping to resolve any critical properly prepared patient items that have not been completed (i.e. patient demographic and insurance/registration verification). Lastly, the Centralized Check-In department is responsible for greeting patients on specified floors within the campus to ensure patients are in the right place for their initial/next episode of care.

Function/Duties of Position

Customer Service

• Provides high quality customer service to both external and internal that meets or exceeds the service standards of the health care industry.
• Provides flexible coverage to assist with internal service needs and the continuous application of process improvement methods and skills.
• As problems and miscommunications occur with internal or external customers, demonstrates the ability to clarify and resolve problems immediately to avoid further communication breakdowns.
• Demonstrates knowledge of all department locations, units, and buildings on OHSU Campus.
• Answers multi-line telephone inquiries. Determine caller needs and assist callers efficiently and appropriately.
• Determine priorities and act quickly, make decisions efficiency and in a calm manner in emergency and stressful situations.
• Upholding institutional policies regarding general public areas on OHSU campus and inside OHSU buildings. This includes screening patients, visitors, vendors and vendor reps as well as reminding them of the policies.
• Liaison between clinical team, practice leaders, and case management for complicated patients and family members.
• Utilizes appropriate interpreter services when necessary.

Patient Registration/Interviews

• Gathers, adds, updates, and/or verifies detailed demographic information and completed/signed forms required for services. These functions are performed at stationary computer terminals, occasionally over the phone or at beside with paper forms and/or a tablet. Hand written documentation may only be utilized during computer downtime or device malfunction.
• Completes Race, Ethnicity, Language, and Disability (REALD) questionnaire with patient face to face or over the phone and updates REALD Smart Form as required by law. Serves as liaison for patients and families with questions.
• Satisfies state regulations to identify support persons for individuals with disabilities.
• Correctly identifies patient service type to establish an accurate and billable account.
• Schedules reservations into Epic with a base knowledge of diagnoses and procedures.
• Validates appropriate admitting locations by procedure and admitting provider to ensure appropriate patient placement.
• Provides patient education regarding OHSU financial assistance, insurance coordination of benefits, Patient Rights, Terms & Conditions, Advance Directives, Medicare Secondary Payer Questionnaire, Medicare and Commercial notices of Non-Covered services (ABN or NCCF), Important Message from Medicare, Release of Information, Special Consent, Champus Message to patients and their representatives, Notice of Privacy Practices, use of patient information and/or specimens in OHSU research, and other facility or regulatory documents.
• Responsible for all identity management corrections after hours.
• Identifies and collects co-pays, deductible payments, deposits, and prepayments for services as required.
• Creates and assembles surgical patient intake form packets for the surgical floors.
• Determines urgent/emergent medical situations and activates rapid response team or engages the assistance of nursing staff to assist.

Enrollment & Authorization

• Gathers, adds, updates, and/or verifies patient information including detailed demographics, detailed insurance coverage/benefits, MyChart enrollment, and financial status with each patient over the phone or face to face.
• Creates new and maintains existing insurance coverages/guarantors for a patient based on their insurances and the care being provided.
• Creates new and maintains existing insurance coverages/guarantors for a patient based on their insurances and the care being provided.
• Obtains benefit information including deductible or co-pays, co-insurance, stoploss or out of pocket status, and correct billing address.
• Complete insurance verification on each patient’s insurance 100% of the time when the insurance verification status says New, Elapsed, Incomplete, Needs Review, or is Medicaid, using electronic verification in RTE, payer portals, or other required methods. The PAS Revenue Cycle Specialist staff will also re-verify the eligibility insurance information if the insurance was not verified in the current month.
• Reviews MMIS for all uninsured or single coverage patients.
• Refers all non-sponsored patients to Oregon Health Plan (OHP) and provides information for financial assistance, working closely with Financial and Medicaid Services.
• Maintains current information on managed care insurance plans and serves as a liaison and information resource for patients, referring physician offices, and other OHSU staff. Applies problem solving and negotiating skills in resolving patient concerns and managed care related issues.
• Maintain knowledge pertaining to insurance issues which includes but is not limited to motor vehicle, workman’s compensation, personal injuries, Medicare, OHP/Washington Welfare/Medicaid, and exposures.

Other duties as assigned.

Required Qualifications

• High School diploma or equivalent.
• One year of experience in a medical office setting, including high-volume direct patient contact, scheduling of appointments and registration and/or billing responsibilities. OR
• Two years of work experience in a high-volume direct public contact, front-line non-healthcare setting position.

Knowledge, Skills, and Abilities

• Basic computer skills including word processing and Windows applications.
• Basic computer keyboarding skills including typing of minimum 40 wpm.
• Demonstrated working knowledge around insurances and benefits.
• Demonstrated excellent verbal and written communications skills.
• Strong customer service orientation.
• Demonstrated effectiveness during extremely confrontational customer interactions in a high stress environment.
• Demonstrated advanced PAS user skills or equivalent as well as extensive knowledge of integrated care models.
• Ability to walk and stand for 6-8 hours per day, position is extremely mobile.
• Must be detail oriented, highly accurate and able to multi-task in high volume situations.
• Must be able to work independently with little direct supervision.

Preferred Qualifications

• Prior experience in medical office front desk and high patient volume.
• Experience with Epic.
• Knowledge of PAS procedures and integrated care at OHSU preferred, and/or completion of a PAS Trainee program.
• Knowledge of OHSU network systems, including Outlook and Microsoft Office products.
• Knowledge of scheduling and front desk.
• Basic medical terminology.

Additional Details

Monday - Sunday (variable); 5:00am - 8:00pm (variable).Locations are variable.

Benefits

• Healthcare for full-time employees covered 100% and 88% for dependents.
• $50K of term life insurance provided at no cost to the employee.
• Two separate above market pension plans to choose from.
• Vacation - up to 200 hours per year dependent on length of service.
• Sick Leave - up to 96 hours per year.
• 9 paid holidays per year.
• Substantial Tri-Met and C-Tran discounts.
• Employee Assistance Program.
• Childcare service discounts.
• Tuition reimbursement.
• Employee discounts to local and major businesses.

Why apply to OHSU?

We are Oregon's only public academic health center. In addition to caring for patients, we lead groundbreaking research. We also train the next generation of health care professionals. As Portland's largest employer, we give you opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington. All are welcome. OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti-racist, multicultural institution and encourage people with diverse backgrounds to apply. To request reasonable accommodation, contact askhr@ohsu.edu