OHSU is Oregon’s only public academic health center. We are a system of hospitals and clinics across Oregon and southwest Washington. We are an institution of higher learning, with schools of medicine, nursing, pharmacy, dentistry and public health – and with a network of campuses and partners throughout Oregon. We are a national research hub, with thousands of scientists developing lifesaving therapies and deeper understanding. We are a statewide economic engine and Portland’s largest employer. And as a public organization, we provide services for the most vulnerable Oregonians, and outreach to improve health in communities across the state.

 

As the Medicare Follow-up Rep (Patient Account Rep) is responsible to follow-up, process adjustments, collect on accounts, and/or perform customer service duties to ensure that monies due to OHSU Hospitals & Clinics are secured and paid in a timely manner and the AR outstanding days of revenue are kept to a minimum. Assignment will be flexible depending on the payer mix, patient flow and workload fluctuations. Serves as a Medicare RAC audit liaison between the Office of Integrity and PBS.

Third-Party Follow-Up and Collection

• Analyze and follow-up on Medicare accounts on AEOS worklist and take appropriate action(s) to resolve all account balances. STANDARD: 250 action items (average, depends on staffing)
• Supply needed information to Medicare that will expedite processing of payments, i.e., resubmit claims, correct Return to Provider claims, prepare appeals, communicate with various third parties and our patients.
• Process financial allowances, contract allowances and other adjustments as appropriate.
• Access various systems to check claim status and eligibility. Systems may be online or require phone contact. Responsible for maintaining a high level of security and confidentiality in the use of these systems.
• Update account insurance coverage as appropriate.
• Calculate outpatient MSP claim reimbursement and determine if billing is necessary.

Customer Service

• Receive phone calls from Customer Service and other Patient Business Services sections. Analyze account activity to provide explanations and resolve customer concerns. Update account information as needed.
• Review inappropriate charges, determine which accounts should be escalated to supervisor’s attention, and take necessary steps to resolve customer concerns.

Other Duties as Applied

• Two years of recent (within the last 5 years) experience billing or collecting healthcare accounts in a business office;  OR

• Four years of general collection, billing or customer service experience; OR

• Equivalent combination of education and experience. 

• Certified Revenue Cycle Specialist (CRCS) is required within 18 months of  hire.

• Recent Microsoft Office applications experience in Windows environment (within the last 2 years)
• Recent online payer experience (within the last 3 years)
• Current Medicare program knowledge (within the last 3 years)

Job Related Knowledge, Skills and Abilities (Competencies):

• Familiarity with medical terminology
• Typing 55 WPM
• Ability to use multiple system applications 
• Strong written and oral communication
• Legible handwriting 
• Detail oriented, analytical 
• Ability to interpret regulations 
• Punctual, good attendance, positive attitude 
• Ability to work in high volume, production environment 
• Excellent customer service skills 
• Knowledge of CPT, HCPCS, ICD-10 coding 
• Strong self-directed work ethic and ability to exercise independent judgement

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.