The purpose of this position is to collect and record accurate and complete required demographic, insurance, and financial information for patients receiving outpatient services. This includes financial screening services, checking insurance eligibility, confirming health insurance coverage, scheduling appointments, and assisting patients in an office orclinic setting.
This position is within the Ambulatory Float Pool and requires flexibility to be willing to work in a variety of clinics and locations with little or no advance notice of assignment. The person in this position must be able to work at multiple locations (all ambulatory clinics in the Tri-County area) over the course of the typical work week and possibly the same day, providing own transportation.
Pay Range: $23.63 - $31.98 per hour
Customer Service: Provides high quality customer service to both external customers (patient, referring providers, and insurance carriers) and internal customers (OHSU health care providers and staff) that meets or exceeds the service standards of the health care industry. This duty includes prompt and professional communication efforts, face-to-face customer contact skills, crisis management, facility with available information technology, standard complaint processing, flexible coverage of internal service needs, and the continuous application of process improvement methods and skills.
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. Obtains authorizations for clinical care, procedures, and laboratory studies. Enters all information accurately into OHSU databases or into the medical record when necessary. Follows up on pending authorizations until they are obtained.
Arranged Care: Schedules new patient appointments on line and manually if necessary. Obtains prior medical records and studies if appropriate. Creates a medical record if needed. Arranges stretchers, wheelchairs, and interpreters when necessary, and accommodates other special needs whenever possible. Mails information packets. Provides personal reminders to patients about upcoming appointments. Obtains and prepares OHSU medical records before scheduled appointments.
Training and Competency: Successfully complete the required initial training and competency assessment during the probationary period. Complete all required updates and attend staff meetings/in-services as scheduled. Maintain all OHSU and department competencies, and demonstrate continuous application of these skills throughout the period of employment. Demonstrate the ability to participate in and/or implement team decisions. Integrate changes to the EPIC system, the third party guidelines and changes to internal processes and procedures into individual registration routines to ensure that current processes are being used consistently. Take personal responsibility to work autonomously, perform optimally each day, and ensure all performance standards are met. Accept change as an opportunity for growth, learning and development, adapting to changing procedures and goals in a cooperative and positive manner. Be self-directed in assessing strengths and weaknesses and in identifying performance enhancement and career development opportunities.
Point of Service Operations: Greets patients and confirms that an appointment has been kept. Inspects insurance cards and/or authorization notices. Identifies and collects deductible payments, co-payments, and deposits on services; provides receipts and completes necessary accounting procedures. Verifies and updates the common data set on-line. Explains and satisfies any necessary patient signature requirements. Validates parking.
Integrated Care: Arranges and orders associated clinical, diagnostic, or laboratory services; obtains 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. Schedules return appointments on line, and manually if necessary; initiates authorization requests for subsequent care.
Telecommunications: 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.
Training and Competency: Successfully completes the required PAS initial training and core competency assessment before or during the trial service period. Completes all required update modules. Maintains core competencies, and demonstrates continuous application of these skills throughout the period of employment
Six Months of recent experience in a medical office and/or medical billing setting, including high-volume direct patient contact, scheduling and/or registration, claims processing, and/or managed care authorizations; OR one year of work experience in a high volume direct public contact position.
Typing by touch 30-45 wpm.
Must have demonstrable record of reliable attendance, exemplary customer contact skills, punctuality, and proven successful performance at most recent past and present employers.
Must have good grammar.
Ability to perform the job duties with or without accommodation.
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