This position is a supporting role within the Centralized Managed Care department. This team completes managed care activities to include benefit verification, preauthorization, notification and patient estimates.

 

The CMC Coordinator position will assist the leadership team in hiring and interviewing functions, new employee orientation, providing ongoing training, and guidance to all of CMC staff as well as helping to standardize process. The CMC Coordinator is to serve as a subject matter expert on CMC staff duties. This position coordinates staff members' ability to work from home. They will Troubleshoot equipment problems and initiate new equipment requests. Required to maintain equipment and space inventories. The Coordinator serves as an ITG Network Contact and Unified Communications phone counselor for the department. They serve as the department timekeeper. The Coordinator assists leadership with implementing new processes and coordinating new and ongoing projects.

Customer Service

• Provides high quality customer service to both external customers (patients, referring providers, insurance carriers, etc.) and internal customers (OHSU health care providers, clinical staff, etc.) via verbal and written communication.
• 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.

Centralized Managed Care Operations

• Maintains current working knowledge of managed care, insurance verification, and patient estimate practices and policies as well as third party payer changes and requirements.
• Shares expertise and disseminates information to Patient Access Services (PAS) Departments, OHSU practice staff, and OHSU ancillary departments.
• Serves as an expert user of registration, cash collections and patient systems software including Epic Prelude, ADT, and Cadence System Modules, Patient Estimates, Third Party Guidelines (TPG), and other third-party insurance websites.
• Prepare and maintain documentation for all CMC staff productivity.
• Provides targeted training for staff members.
• Performs QA’s based on staff productivity and feedback provided by external departments. Forwards information to appropriate staff member and assures correction of information is completed and documented.

Personnel Operations

• Coordinate with employment supervisor for pre-hire and onboarding processes to include new employee checklist and activities to ensure all required training, access, etc. is completed for new employees.
• In collaboration with the department trainer, provides on the job orientation and department specific training for new personnel.
• Make arrangements for new personnel to attend other required training including NEO and online modules required as the onboarding process.
• Recommends updates to the CMC policy and procedures, assuring updated or new material is added as necessary. Communicates with staff regarding policy and procedure updates.
• Works conjointly with the employment supervisor to counsel employees, develop work plans, and when requested, provides supervisor with input regarding progressive discipline.
• Prepares PAS-R Performance Assessments and provides this documentation to leadership.
• Provides CMC services to patients as needed to assure adequate staffing during times of high demand in order to meet department’s customer service expectations.

Administrative Functions

• Serves as primary Timekeeper for the department. Sending bi-weekly reminders to the department to ensure timecards are completed prior to pay period close.
• Prepares Personnel Actions and Labor Distribution in HRE.
• Maintains a clean, safe, and orderly environment for department staff.
• Notifies appropriate personnel when cleaning and repair of equipment is needed.
• Serves as primary responsible party for ordering and receiving office supplies and equipment.
• Maintains adequate inventory of supplies for department.
• Schedules and assists in the preparation of agendas and presentations for department meetings
• Troubleshoots equipment problems and initiates new equipment requests.
• Serve as an ITG Network Contact and telecommunications phone counselor for the PAS cluster.
• Other duties as assigned.

• Two years of front-line clerical experience in a clinical setting with direct patient contact. 
• Experience must include scheduling of appointments and may require experience obtaining managed care authorizations (dependent on position description). 
• Preference given to candidates with knowledge of OHSU’s PAS policies and procedures, with completed PAS training and core competencies, and with previous PAS experience.

Knowledge, Skills, and Abilities

• Must have a demonstrable record of reliable attendance, punctuality, and proven successful performance at past and present employers. 
• Must have demonstrated evidence of strong written and verbal communication skills.
• Ability to work independently.
• Willingness to serve as a positive and professional role model.

• Proficient, expert user of OHSU computer applications including Epic Referrals, Excel, Windows, OHSU Intranet and on-line verification systems.

• Proficient at basic keyboarding skills including typing 35-45 wpm.

• Demonstrated knowledge of OHSU policies and procedures governing managed care processes, and billing for outpatient and inpatient services.

• Exceptional customer service skills, both in person and over the phone.

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

• Minimum of two years of experience in OHSU Epic Referral system including referrals and auth/cert records.

Hours of work: 40-hour work week, Monday - Friday, during operational hours of 7:00am - 5:30pm. 

Work Location: Remote and occasionally downtown Portland (Fifth Avenue Building).

Must be able to share office space with other coworkers and able to multi-task in a high-volume environment.

 

 

Benefits 

• Healthcare for full-time employees covered 100% and 88% for dependents.
• $50K 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 dependent on length of service.
• Sick Leave - up to 96 hours per year.
• 9 paid holidays per year.
• Substantial Tri-Met and C-Tran discounts.
• Employee Assistance Program.
• Childcare service discounts.
• Tuition reimbursement.
• Employee discounts to local and national businesses.

We are Oregon's only public academic health center.

In addition to caring for patients, we lead groundbreaking research. We also train the next generation of health care professionals. As Portland's largest employer, we give you opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington.

All are welcome.

OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti-racist, multicultural institution and encourage people with diverse backgrounds to apply.

To request reasonable accommodation, contact askhr@ohsu.edu