OHSU Casey Eye Institute is a premier academic medical center providing eye care for adults and children in the Pacific Northwest and beyond. We treat eye conditions from the most straightforward to the most complex and offer expert care in all ophthalmology specialties. 

 

Since 1945, OHSU Casey Eye Institute doctors and vision scientists have worked side by side to discover the causes of eye disease and find new treatments. Bringing research and patient care together helps us turn possibilities into realities OHSU Casey Eye Institute is a "High Performing" eye hospital, which means we are ranked in the top 10 percent nationally by U.S. News & World Report.

 

The purpose of this position is to provide support to the Comprehensive Optometry and Medical Contact Lens Division in the areas of managed care, insurance authorizations/verifications, billing work queues and back-up for phones, reception, scheduling, and other duties as assigned. This is a full-time, benefitted, on-site position.

Managed Care & Billing:

 

Obtains all authorizations, including retroactive authorizations, contacting primary care physicians or their designees to obtain authorizations for care as required. The authorization process includes, but is not limited to, putting the referrals information on-line, tracking the number of visits used per authorization, following up on referrals for return appointments and other miscellaneous tasks. 

 

Gathers and/or verifies patient information including demographics, insurance coverage, and financial status. Educates patients , face-to-face when necessary, on related billing issues as appropriate; quoting self-pay or deposits where indicated. Obtains authorizations for clinical care, procedures, and laboratory studies.  Follows up on pending authorizations until they are obtained.  Works closely with Faculty and staff to ensure authorizations/referrals in place prior to any appointments, diagnostics or procedures involving managed care patients. Manage billing work queues as assigned which may include back-up for follow-up work queues. Serves as a resource for insurance and billing questions for patients, staff and referring physicians. Maintains current information on all managed care insurance plans and is up to date with all managed care insurance plan changes, utilizing information to efficiently and effectively obtain authorizations. Strong knowledge of OHSU insurance contracts with medical and vision carriers and the ability to explain the billing differences to patients, staff and referring physicians. Answers insurance questions for all patients, scheduled or non-scheduled, directing patients to appropriate provider for other health care issues. Attend managed care coordinator meetings at OHSU and billing meetings at Casey Eye Institute to maintain billing knowledge and obtain new information. 

 

Other duties may include back-up phones, scheduling, check in/out, cash handling, and other duties as assigned by supervisor.

 

Enters all information accurately into OHSU databases or into the medical record when necessary.

One year of experience in a medical office setting, including high-volume direct patient contact, scheduling of appointments and obtaining managed care authorizations. 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.

 

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.  Proficient in university network computer applications using Windows, PowerPoint, Cadence, EPIC and related applications.  Working knowledge of medical terminology.  Strong relationship building skills with patients, health plans, providers, staff, management.  Exceptional customer service skills - both in person and on the phone.  Patient advocacy skills - evaluate patient concerns for timely resolution.  Sensitivity to patient needs. Demonstrated evidence of strong written and verbal communication skills.  Ability to manage competing priorities.  Ability to meet deadlines and urgent patient and system needs.  Ability to work independently; willingness to serve as a positive and professional role model. 

High school diploma or GED preferred.

 

Ophthalmology/vision insurance experience strongly preferred.

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.