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 PAS Resource Specialist in this role will function as the Surgery Coordinator for the Glaucoma Division at Casey Eye Institute and will be responsible for coordinating all aspects of the surgery program. This includes the scheduling and authorization processes for 5 Glaucoma physicians and 2 fellows under the direction of the Practice Manager and Clinical Operations Director. Duties include, but are not limited to, obtaining all appropriate surgical indications from attending physicians, making decisions regarding appropriate scheduling of the department OR block time, obtaining accurate insurance information from patients in order to procure insurance authorization for the surgical procedure, and coordinating all aspects of the individual surgical procedure for multiple specialty-specific providers. This is a full-time, on-site position. 

 

Pay Range: $25.86 - $34.95 per hour, Commensurate with Experience

Obtains authorizations, including retroactive authorizations, contacting primary care physicians or their designees to obtain authorizations for care as required; identify, sort, and distribute authorizations received for other services in the department as they are sent to the division. 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 on related billing issues as appropriate; quoting self pay or deposits where indicated. 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. Works closely with Residents, Faculty and staff to insure authorizations/referrals in place prior to any appointments, diagnostics or procedures involving managed care patients. Requests referrals/authorizations for patients when COA physicians refer these managed care patients to specialists. On a daily basis, pulls next day’s authorizations, Gives authorizations/referrals to front desk to place in patient charts. Maintains file of authorizations for scheduled appointments. Utilize EARL system for referrals. 

Clinical Operations Monitoring; Serves as a resource for training PAS staff for insurance and billing questions from 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 patients, scheduled or non-scheduled, directing patients to appropriate provider for other health care issues. Investigates clinical scheduling errors, working with staff and providers, recommends operational changes as needed. Investigates claim denials, particularly for evidence of PAS non-compliance; communicates findings to appropriate PAS personnel and providers. Investigates patient and provider complaints and develops appropriate corrective action plan.

Clinical Service Resource; shares PAS expertise and disseminates information to other PAS personnel. Serves as an expert user of PAS systems software to include Order Entry, Earl and Cadence Scheduling. Maintains working knowledge of skills in the area of insurance authorizations, arranged care, point-of-service operations, integrated care and telecommunications.

 

Schedules appointments for authorizations/referrals from inside and outside sources when necessary. Completes and routes direct referrals to other clinical services. Provides high quality customer service to patients, OHSU faculty and referring providers, to include PCP’s and their office staff, insurance providers in requesting referrals, and co-workers. Maintains a high standard of patient interactions skills and is exemplary in addressing patient complaints when necessary. Accesses scheduling system and inserts additional notes in Cadence regarding insurance updates and adds instructions for front desk staff. Is available as a resource if patient or staff needs additional authorization/insurance information upon checking in for appointment. Collaborates with COA lead worker to insure patients seen by Resident on call after hours are billed appropriately, insurance benefits are reviewed, demographics updated if necessary and retro referrals are obtained where indicated.

 

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. These duties include prompt and professional communication efforts, face to face customer contact skills, crisis management, standard complaint processing, flexible coverage of internal service needs, and the continuous application of process improvement methods and skills. 

• 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.
• 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.

• 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. 

• Exceptional interpersonal skills and ability to resolve conflicts and problem-solve between parties. 

• Demonstrated evidence of strong written and verbal communication skills. 

• Ability to manage competing priorities. 

• Ability to meet deadlines and urgent system needs. 

• Ability to work independently; willingness to serve as a positive and professional role model. 

• Must have demonstrated record of reliable attendance, punctuality and proven successful performance in past and present.

• High School Diploma or GED preferred.

Must be able to have a flexible work schedule, determined by the needs of the clinic.
Must use public transportation, as parking will not be provided. Applicants must be willing to travel between clinic sites by stairs, elevator, tram, shuttle or other means.

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.