The PAS Resource Specialist is responsible for providing the highest level of customer service while handling all aspects of the scheduling of clinic appointments, ancillary services and managed care for the Practices with CDRC. This position is responsible for all aspects of managed care and it relates to Doernbecher Children’s Hospital and OHSU Managed care practice standards. 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 will assist with the CDRC telephone calls as requested by management.

Key Responsibilities & Performance Standards

 

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. Educates patients of pre-pay amounts, monitors provider’s schedules and other managed care duties as assigned. Fills out patient financial responsibility forms when necessary. Enters all information accurately into OHSU databases or into the medical record when necessary

Arranged Care: 

• Schedules New and return patient appointments and coordinates any ancillary appointments. Cross-coverage of other GS Scheduler positions that would require facilitating medical review and scheduling new patients for other GS specialties. Obtains prior medical records and studies when appropriate. Creates a medical record if needed. Monitors provider’s schedulers to fill cancellations, no-shows and records needed for each provider. Arranges stretchers, wheelchairs, and interpreters when necessary, and accommodates other special needs whenever possible. Mails information packets to patients.

Integrated Care: 

• Arranges and orders 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.

Managed Care Coordination:

• Maintains current information on managed care insurance plans and serves as a liaison and information resources for physicians, nursing support staff, and coworkers, referring physician offices, OHSU Health Plan Office, patients, and insurance companies on authorization requirements per diagnosis and service. Serves as service area expert on ICD9 coding requirements and issues. Obtains managed care authorizations for all consultations, procedures, office visits, and care arrangements by scheduling appointments and contacting other ancillary and clinical services as needed. Applies problem solving and negotiating skills in resolving patient concerns and managed care related problems.

Telecommunications and Administrative Duties: 

• 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 (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.

• HS Diploma or advanced degree preferred. 
• Experience in a medical office setting.  
• Appointment scheduling experience. 
• Basic computer keyboarding skills including typing of 40-50wpm.
• Proficient computer skills including word processing.
• Extremely high level of attention to detail.  
• Demonstrated problem solving and negotiation skills in resolving patient concerns, scheduling challenges and managed care related problems. 
• Knowledge of Epic systems. 
• Knowledge of OHSU network systems, including Outlook and Microsoft Office products. 
• Communication and contact:  Communicates effectively both verbally and in writing with superiors, colleagues and individuals inside and outside OHSU
• Active listening skills; ability to deal with customers in stressful situations; ability to remain calm under pressure
• Relationships with others:  Works effectively and relates well with others including superiors, colleagues and individuals inside and outside OHSU
• Exhibits a professional manner in dealing with others and works to maintain constructive working relationships
• Excellent customer service skills both in person and on the telephone
• Ability to work in a collaborative, team-centered work environment and provide helpful support in a timely manner
• High level of integrity
• Tolerance for ambiguity in a high workload, fast-paced environment
• Attendance and dependability:  Can be depended on to report to work at the scheduled time and is seldom absent from work; can be depended upon to complete work in a timely, accurate and thorough manner and is conscientious about assignments; willing to work overtime as necessary depending on volume of work

• This position works in a busy environment with many interruptions, multiple demands and interactions. This position will handle a high volume of patient phone calls, high level of multi tasking, and scheduling.
• This position requires sitting for at least 2 hours at a time. Heavy use of computers and multi-line phones. Ability to lift and carry 25 pounds. Ability to speak clearly, demonstrate patience and understanding of customer needs. Must be able to deal with competeing needs and priorities of internal customers. 

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.