The PAS Resource Specialist is responsible for providing the highest level of customer service while handling all aspects of the scheduling of clinic appointments, surgery, ancillary services and managed care for the Department of Plastic and Reconstructive Surgery. This position is responsible for all aspects of managed care and it relates to the PLS and OHSU Managed care practice standards. It is also responsible for providing accurate/correct and timely fee quotes to patients for cosmetic procedures. This position will respond to patient care scheduling requests which include but are not limited to, patient phone calls, MyChart or provider request. This position serves as a liaison and information resource for clinicians, coworkers, referring providers, patients and external vendors. This position can be assigned to back up PLS phones.
Enrollment & Authorization: Gathers and/or verifies patient information including demographics, insurance coverage, and financial status. Confirms patient eligibility for health care coverage and clarifies any managed care arrangements. Educates patients of pre-pay amounts, monitors provider’s schedules and other managed care duties as assigned. Enter all information accurately into OHSU databases and /or into the medical record when necessary. Document managed care in system accordance with OHSU best practices. Works closely with coding specialists to ensure accurate reimbursement. Fills out patient financial responsibility forms when necessary. Enters all information accurately into OHSU databases or into the medical record when necessary. Accurately quotes and collects fees for cosmetic procedures where applicable.
Arranged Care: Schedules New and return patient appointments and coordinates any ancillary appointments. Cross-coverage of other PLS Scheduler positions and coordination of care. Obtains prior medical records and studies when appropriate. Creates a medical record if needed. Monitors & fills provider’s surgery schedule. Arranges stretchers, wheelchairs, and interpreters when necessary, and accommodates other special needs whenever possible. Mails information packets to patients.
Integrated Care: Arranges and coordinates associated clinical, diagnostic, or laboratory services; authorizations when necessary. Directs patients to appropriate providers for other health care issues. Completes and routes direct referrals to other clinical services. Contacts primary care physicians or their designees to obtain authorizations for urgent care. Triages and documents accurately telephone calls from patients including requests for medication refills, complaints, general information inquiries, and urgent health care concerns. Delivers such information or requests promptly to the appropriate providers or their designees. Other administrative duties as assigned.
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