The Comprehensive Pain Center (CPC) team includes physicians, psychologists, physical therapists, nurse practitioners, chiropractors, acupuncturists, rolfers, massage therapists, and a naturopath who deliver truly comprehensive care and offer more training opportunities for fellows and residents. Patients benefit from both traditional (e.g., blocks, pumps, stimulators) and non-traditional (e.g., biofeedback and acupuncture) pain management techniques. The department is also nationally recognized in pediatric pain management.
This position is an initial point of contact for patients to OHSU. They are the face and voice of the OHSU Comprehensive Pain Center. The position must be motivated to create the ideal patient and family experience. The position works with patients, families, providers, clinical and non-clinical staff to coordinate the patient¿s experience throughout the process of accessing healthcare at OHSU. This position provides managed care, authorization, and scheduling activities. The position is responsible for gathering and verifying patient information including demographics, insurance coverage and financial status. The position has responsibility for checking insurance to verify eligibility of health care coverage for all clinic visits, obtaining authorizations for clinical, procedural, and surgical visits, and communicating with patients the status of their insurance for visits. Maintains current information on managed care insurance plans and serves as a liaison and information resource for clinical staff, colleagues and insurance companies. Applies problem solving skills in working with insurance companies, FPP and Hospital Financial Services in resolving patient concerns and billing related problems. Responds to patient, staff and provider questions regarding insurance coverage. Schedules patients as needed to coordinate care or to ensure authorizations can be obtained for services.
Ensures check-in staff have all information and documents in place for a smooth, efficient, and complete check-in process. This includes, but is not limited to, careful review of insurance and demographic information with each patient and verifying insurance benefits, obtaining authorization, indicating information on copays, deposits, estimates, forms such as ABNs, NCCFs. OHP waivers. Clarifies questions from PAS Scheduling staff regarding insurance coverage for scheduling. Communicates with patients and check-in staff (Comprehensive Pain Center, ENT, and Beaverton CCI) when questions or discrepancies arise. Communicates with providers if there are concerns about coverage for requested services or orders.
This position follows defined Standard Work expectations for CPC and Ambulatory, and meets defined productivity metrics. Continually works with all Comprehensive Pain Center care teams members (RN, MA, front desk, schedulers, providers, CPC leadership, and billing support teams) to streamline daily patient flow, ongoing patient care needs, communication, participates in workflow process improvement projects & departmental or OHSU quality initiatives. Participates as part of the MCC team on workflows for continuous improvement. Customer Service Excellence: Meet or exceed customer service standards in all interactions with patients, families, and all healthcare team members. Provide prompt, professional and courteous communications at all times. Other duties assigned by the Practice Manager or PAS Supervisor This position will spend 100% of their time on phones and/or other types of communication. This position requires high level attention to detail while providing the highest level of service to our patients, clinical team, and colleagues. The position is also involved in recognizing and reporting barriers to their immediate supervisor.
Wage range: $24.62 - $33.28 per hour
Customer service excellence and Telecommunications
Benefits and Authorizations, Managed Care coordination, Surgery Scheduler, Scheduling
Integrated Care, Communication, Workqueues, Information Resource
Other duties as assigned
High School Diploma or GED
At least one year of experience in an ambulatory clinical setting. Including high-volume scheduling of appointments, multi-line phone system, obtaining managed care authorizations..
Must have thorough knowledge of PAS polices and procedures, and demonstrated advances PAS user skills.
Advanced computer skills, including Microsoft Word and Excel , OHSU Epic skills and online resource use knowledge.
Excellent communication skills, both written and verbal
Demonstrated knowledge of managed care policies and procedures including appropriate timelines, paperwork, regulations, communication and follow-up are also required.
Demonstrated efficiency, problem solving and negotiation skills in resolving patient concerns and managed care related problems.
Must meet Department performance standards measuring efficiency, production, timeliness and accuracy. This will be reviewed on a regular basis both as a team and as an individual.
Ability to multi-task in a high volume situation.
Strong attention to detail and processes
Ability to work autonomously, with a high level of accuracy, speed and exhibit a willingness to work with deadlines.
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