***This is a 6 month limited duration assignment***

 

The Limited Duration Managed Care Coordinator position at the University Fertility Consultants practice is responsible for the completion of all daily Managed care duties. This includes; verifying insurance eligibility and benefits, contacting patients with estimates of upcoming appointment cost, submitting prior authorizations to insurance companies, maintaining the Referral Work-queue, tracking billing issues, coordinating with billing to resolve billing issues, collecting payments and communicating with patients regarding their insurance coverage. In addition the Managed Care Coordinator will work directly with the Financial Counselor as support and back-up regarding patients seeking IVF treatment, directly meeting and educating patients regarding coverage, fertility plan options, costs, and expected pre-payments.      

 

Managed Care Coordination

• Verify benefits and eligibility
• Update insurance & patient demographic information as needed
• Meet/Communicate with patients who have questions regarding their insurance coverage.
• Review schedules (next day, one week and two weeks out) for referrals, coinsurances, etc.
• Notify patients of coinsurance/self-pay amounts prior to appointment.
• Collect & post payments
• Request, obtain and enter referrals
• Submit and follow-up on prior authorizations to insurance companies
• Referral Work-queue, monitor and document accurate up to date information
• Track and follow up on billing issues; to ensure they are resolved in a timely manner
• Coordination with billing to resolve billing issues
• Maintain current information on all managed care insurance plans and remain up-to-date with all managed care insurance plan changes utilizing information to efficiently and effectively obtain authorizations.
• Ensure Managed Care Forms; NCCF, ABN and Patient Estimate forms are complete and given to front desk in advance of patient visit.
• Ensures appropriate financial information is recorded in appointment comments for collection and NCCF signing purposes.
• Manage and maintain the referral report in EPIC referral including referrals to submit, referrals received, benefit check pending, exception report, and ready to schedule report.
• Manage and maintain the CWH managed care DAR 

Back up the Financial Counselor as needed;

• Meet with each patient after initial IVF consult
• Map out financial options with patients, including ARC, IntegraMed and private insurance.  Comes up with individual financial plan for each patient based on patient individual needs and insurances.
• Interface with ARC & Attain to maintain packages, pricing, manage payments.
• Review offsite log, includes obtaining authorizations when necessary.
• Complete patient assistance paperwork; follow up, including IntegraMed and ARC.
• Maintain all communication for follow up paperwork with IntegraMed and ARC.
• Primary liaison to IntegraMed and ARC.
• Notify patient accounts representatives of self-pay patients.
• Creates tracking system for patient’s financial needs using Excel spreadsheets. 
• Manages oncofertility referrals; determines insurance benefits or seeks AYA approval.

Other Duties & Responsibilities

• Provides secondary coverage for other PAS Resource Specialist daily, and back up for vacation/sick time.  This includes patient check in/out, receiving payments, answering phones, scheduling and filing.
• Help cover for other staff when they are out of the office.
• Performs other duties as needed or requested.

• 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
• Must be able to perform the essential functions of the position with or without accommodation

• 4 year college degree
• Experience in women’s health care setting.
• 1 year experience in a business office operations (outpatient setting), performing insurance verification, financial counseling and patient accounting for patients.  Experience in managed care.
• Experience working in a busy environment with many interruptions while communicating effectively with patients, providers, coworkers, vendors, etc.
• Experience in a customer service role.
• Epic proficiency
• Bilingual Spanish
• Strong computer skills and experience using healthcare billing and collection computer system; word processing and spreadsheet software (experience with Excel spreadsheets), internet and phone systems.

 

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.


As an organization devoted to the health and well-being of people in Oregon and beyond, OHSU requires its employees to be fully vaccinated against COVID-19.