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.

• 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. 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.

 

 

• Previous experience with EPIC. 
• Minimum of 6 months experience with high volume, multi –line phone system. 
• Proficient with MS Office (including Outlook, Word, and Excel). 
• Working knowledge and understanding of medical terminology. 
• Thorough knowledge of electronic patient scheduling programs
• Experience with database entry.
• Demonstrable record of reliable attendance, punctuality, and proven successful performance at past and present employers.
• Demonstrated exemplary written and verbal customer service skills and communication skills.
• Strong customer service orientation.
• Demonstrated effectiveness in customer confrontational interactions.
• Must be detail oriented, highly accurate and able to multi-task in high volume situations
• Demonstrated 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 and attention to detail.
• Demonstrated effectiveness in confrontational customer interactions. 
• Demonstrated excellent problem solving and negotiation skills in resolving patient concerns, scheduling challenges and managed care related problems. 
• Demonstrated understanding of managed care. 

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.