The PAS Resource Specialist in the OHSU Spine Center is responsible for handling all aspects of the scheduling and managed care as it relates to surgery and clinic scheduling processes for all patients using the electronic EMR (EPIC) and the specific OpTime program. This position participates in all training as required as it relates to surgical scheduling and managed care.  This position handles incoming patient calls, schedules clinic and managed care duties necessary to provide seamless service to patients.  This position delivers high level customer service to all internal and external customers.  This position serves as a liaison and information resource for clinicians, coworkers, referring providers, patients and external vendors.

• 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, competency of available information technology, standard complaint processing, flexible coverage of internal service needs and the continuous application of process improvement methods and skills. Check-out patients; Responsible for knowledge of current OHSU cash handling protocol; Proper use of OHSU forms and documentation required for all patients; Follow department specific policy on cancellations and reschedules including proper documentation in the EMR.
• Managed Care Coordination: 
  • Diagnostic MCC, Maintains current information on managed care insurance plans and serve as a liaison and information resources for clinicians, co-workers, referring physician’s offices, patients and insurance companies on authorization requirements per diagnosis and service. Gather and/or verify patient information including demographics, insurance coverage, and financial status. Confirm patient eligibility for health care coverage and clarify any managed care arrangements. Initiates authorization requests for subsequent care. 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. Obtain authorizations for clinical care, and all external ancillary studies. Apply problem solving and negotiating skills in resolving patient concerns and managed care related problems. Follow up on pending authorizations until they are obtained. 
• Call Processing: 
  • Responsible for connecting the patient with the appropriate individual to progress their care in the clinic through warm transfer. Create telephone call encounters from patients in the EMR which will include accurate documentation of requests for medication refills, complaints, general informatin inquiries and urgent health care concerns;  Triage calls to the appropriate staff for patient care /needs assessment; Process calls (answering, screening, routing, paging etc.) in a timely, polite, professional  manner;  Route calls to appropriate conclusion; Provide information to callers, including directions, addresses and hours of operation; Use schedules and departmental procedures to locate appropriate on-call person for internal and external callers.

• 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.

Knowledge and Skills Required:

• 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.

• High School diploma or equivalent.
• Some college coursework.
• Medical office experience and working with patients with spine conditions.
• Formal customer service training.
• Surgery scheduling experience.
• Managed Care Coordination experience
• Referral Coordination experience

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.