Managed Care Coordinator (PAS Resource Specialist)

Oregon Health & Science University; Portland (OR); On-site; USD 40,000 - 70,000; Full time

Job summary

An established industry player is seeking a dedicated PAS Resource Specialist to ensure financial clearance for patient services. This role involves verifying insurance eligibility, assisting with authorizations, and providing exceptional customer service. The ideal candidate will possess strong problem-solving skills and the ability to communicate effectively with both patients and staff. Join a diverse and inclusive team that values cultural competence and offers a dynamic work environment. If you thrive in a busy office setting and are passionate about patient care, this opportunity is perfect for you.

Qualifications

• 1+ year experience in a medical office with direct patient contact.
• Advanced PAS user skills and knowledge of integrated care at OHSU.

Responsibilities

• Verify insurance eligibility and obtain benefits for patients.
• Act as a resource for staff regarding insurance coverage inquiries.

Skills

Customer Service Skills

Problem-Solving Skills

Verbal Communication Skills

Written Communication Skills

Basic Computer Skills

Education

High School Diploma or GED

Associate Degree or higher

Tools

Epic Cadence

Database Skills

Windows Applications

Job description

Department Overview

The PAS Resource Specialist in the Managed Care Coordinator role assures Financial Clearance for services ordered and provided under the patient's insurance. If uninsured, assures that patient is referred to financial counselor for possible assistance. Provides excellent customer service, professional communication, detail oriented and demonstrates excellent problem-solving skills. The PAS Resource specialist works with patients to help them understand their coverage, works directly with providers, clinical and other staff to fulfill job duties.

Function/Duties of Position

• Maintains off-site log or assists peers with maintenance by obtaining authorizations for ancillary service referrals and documentation of such.

• Verifies insurance eligibility and obtains benefits, referrals/prior authorizations and documents in patient’s file. Updates insurance information on patient’s accounts when applicable.

• Reviews orders and documents treatment approvals and locations in patient’s record (EMR). Monitors all treatment regimens for insurance coverage and appropriateness of indication and forwards to Manager/Formulary Committee for approval as needed.

• Functions as a “point of inquiry” and resource for all work unit staff with questions regarding insurance coverage and where scans and treatments may be done.

• Applies problem solving and negotiating skills in working with insurance companies and referring providers to obtain a successful outcome.

• Reviews additions to the schedule of same day and next day appointments from outside OHSU providers for insurance and authorizations of medications to infuse in the day treatment clinic.

Required Qualifications

• 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.

Knowledge and Skills Required:

• Basic computer skills including word processing.
• Windows applications, on-line scheduling, and a preference for database skills.
• Excellent verbal and written communications skills.
• Strong customer service orientation.
• Demonstrated effectiveness in confrontational customer interactions.

Preferred Qualifications

• High School Diploma or GED
• Associate Degree or higher; minimally some college coursework in related field
• Experience in working with chemotherapy drugs in medical oncology setting
• Knowledge of computer applications including Epic Cadence, and EARL

Additional Details

This position works in a busy office environment with multiple, competing demands; frequent interruptions, and interpersonal interactions with both internal and external customers. Hours: 8:30 am - 5:00 pm, M-F.

Position requires employee to travel occasionally between the various offices of the OHSU Community Oncology work unit.

All are welcome

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 [e-mail].