The PAS Resource Specialist is responsible for handling all aspects of the authorization process for Rehabilitation Services outpatient appointments. This will include gathering appropriate and correct patient

demographics, financial information, confirming correct health coverage including managed care arrangements, financial screening, worker compensation status, and non-covered service status. This position works closely with referring providers for treatment authorizations. This position is responsible for informing patients about the billing mechanisms and their financial liability for Department services. This position serves as an insurance and coding resource for all business and clinical staff in the department.

• Responsible for verifying patient eligibility and securing referral/authorization prior to the outpatient therapy appointment. The authorization process includes, but is not limited to, putting the referral information on-line, tracking the number of visits used per authorized, following up on referrals for return appointments, and other miscellaneous tasks. Gathers and/or verifies patient information including demographics, insurance coverage, and financial status. Confirms patient eligibility for health care coverage and clarify any managed care arrangements. Contacts primary care physicians or their designees to obtain authorizations for care as required. Obtains authorizations for therapy. Enters all information accurately into OHSU databases. Follows up on pending authorizations until they are obtained.

• When called upon to do so, shares business expertise and disseminates business and clinical information to PAS Specialists within the Department. Gives instruction to co-workers as needed in skills for business and clinical system software including Medilinks, RSS, Order Entry, and LCR. Maintains a service- based working knowledge of diagnostic and procedural coding. Fills in as needed for any subordinate business position within the service areas. Gives instruction for other business personnel pertaining to business processes and procedures as well as performance. Provides on the job training, orientation, guidance and coaching for new PAS personnel in the service area. May be required to distribute business duties within a defined work-group and to review work for conformance to standards. May be required to provide informational assessment of other PAS workers performance to the PAS Supervisor and/or the employment supervisor.

• May greet patients and check them in prior to being seen by a clinical provider. This includes, but is not limited to careful review of insurance, demographic information, confirming insurance eligibility, and /or authorization. Checks patient account numbers and corrects any problems, seeking advice from Central Registration as required. Ensures that all appointment comment information is accurate and completed. Identifies and collects deductible payments, co-payments, and deposits on services; provides receipts and complete necessary accounting procedures. Explains and satisfies any necessary patient signature requirements. Notifies therapist when patients arrive, monitors the length of the patients wait and intervenes as necessary. Completes other duties associated with efficient and effective

  patient check in. May be responsible for all processes involved in checking patients out after being seen by a clinical provider. This includes scheduling return appointments. Directs patients to appropriate providers for other health care issues. Schedules return appointments on line, and manually if necessary; initiate authorization requests for subsequent care.

• Other 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. 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.

• One year of experience in a medical office setting, including high-volume direct patient contact and scheduling of appointments and obtaining managed care authorizations.
• Knowledge of medical terminology
• Strong customer service orientation
• Ability to manage competing priorities and meet deadlines, urgent patient needs, and system requirements 
• Ability to work independently
• Demonstrated effectiveness in confrontational customer interactions. Previous Rehabilitation Scheduling and authorization work.

Center for Health and Healing 1, Beaverton, Murray, CDRC Locations, Remote

 

Benefits:

• Healthcare Options - Covered 100% for full-time employees and 88% for dependents, and $25K of term life insurance provided at no cost to the employee
  
• Two separate above market pension plans to choose from
  
• Vacation- up to 200 hours per year depending on length of service
  
• Sick Leave- up to 96 hours per year
  
• 8 paid holidays per year
  
• Substantial Tri-met and C-Tran discounts
  
• Additional Programs including: Tuition Reimbursement and Employee Assistance Program (EAP)
  

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.