PAS Resource Specialist

Oregon Health & Science University; Portland (OR); Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Healthcare for full-time employees

Tuition reimbursement

Paid holidays

Employee discounts

Family/ Dependent benefits

Job summary

OHSU's Department of Urology seeks an experienced administrative professional to deliver top-tier customer service to patients and providers in a hybrid Portland setting. You will verify insurance, obtain authorizations, and document information in EPIC Cadence and EARL while supporting daily office operations.

The role emphasizes accurate communication, problem solving for managed care issues, and collaboration with physicians and staff in a busy health system.

Qualifications

• Experience in a medical office setting with high patient volume.
• Knowledge of PAS policies and procedures.
• Proficient with managed care functions including authorizations and referrals.

Responsibilities

• Provide the highest level of customer service to patients, families, and internal staff.
• Gather/verify patient demographics, insurance, and eligibility; obtain authorizations.
• Document information in EPIC Cadence and EARL; resolve denials with management.

Skills

Customer service

High-volume patient contact

Managed care familiarity

PAS policies knowledge

Independent work

Education

Bachelor’s degree or some college experience preferred

Tools

EPIC Cadence

EARL

EPIC system

Job description

Department Overview

The Department of Urology at OHSU is committed to providing the highest quality, state-of-the-art care for adult and pediatric urology patients. Our physicians are recognized leaders in their fields, have advanced fellowship training in urological subspecialties, and are expert, high-volume surgeons. We consider it a privilege to be able to offer this care to our patients and continually strive to provide it with a personalized, patient-centered and compassionate focus. We also take pride in our contributions to new discoveries through research, and embrace our important role in training the next generation of top urologists.

Department Overview

The Department of Urology at OHSU is committed to providing the highest quality, state-of-the-art care for adult and pediatric urology patients. Our physicians are recognized leaders in their fields, have advanced fellowship training in urological subspecialties, and are expert, high-volume surgeons. We consider it a privilege to be able to offer this care to our patients and continually strive to provide it with a personalized, patient-centered and compassionate focus. We also take pride in our contributions to new discoveries through research, and embrace our important role in training the next generation of top urologists.

Function/Duties of Position

Customer Service

• Provide the highest level of customer service to both external customers (patients and their families, referring providers, insurance carriers, etc.) and internal customers (OHSU health care providers and staff) that meet or exceed 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.

Managed Care/Financial Clearance

• Gather/Verify patient and guarantor information including demographics, insurance coverage, and financial status; confirm patient eligibility and benefits for health care coverage directly with the carrier via electronic database, phone, fax or email; clarify any managed care arrangements; obtain authorizations for clinical care, surgeries, procedures and laboratory studies.
• Enter all authorizations, referral and benefit information accurately into EPIC Cadence and EARL. Follows up on pending authorizations until they are obtained.
• Works with manager to resolve any denials related to authorization/enrollment issues in a timely manner.
• 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.
• Determine appropriate TOS payment amounts (including co-pays, co-insurance, deductibles, deposits, prepayments, etc.) and arrange for their collection at the time of service.
• Arrange for T&C forms, NCCF, etc. to be completed by patient 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.

Communications

• Communicates with internal and external customers using Epic, Phone, Teams, etc in a timely manner; accurately documents information; and relays any messages, requests for information, urgent health care concerns and general inquiries to the appropriate source.
• Other Duties As Assigned.

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.
• Proficient with managed care functions including eligibility issues, authorizations, referrals and TOS payments/collections.
• 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.
• Must be able to work independently, with little direct supervision.
• Must have demonstrable record of reliable attendance, punctuality, and proven successful performance at past and present employers.

Preferred Qualifications

• Bachelors degree or some college experience preferred.
• Two years experience in a high volume medical office preferred.
• Experience in a Urology service.
• OHSU PAS experience preferred.
• EPIC experience preferred.

Additional Details

Ability to work general business office hours from 8:00 am to 5:00 pm. Occasionally, there is a need to come in early or stay late to accommodate patient or physician needs and staff meetings. Hybrid position.

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 national 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 [e-mail]