As an OHSU employee, you will find opportunities to teach and mentor residents and fellows, participate in regular Grand Rounds presentations (1 AMA PRA Category 1 Credit), explore opportunities to serve and collaborate with a host of engaged faculty, staff and educators.
The Department has a fully accredited training program that seeks to deliver collaborative, high quality, compassionate, cost effective service that promotes education, research, and clinical leadership.
We are seeking an experienced Board Certified Psychiatrist wishing to participate in this exciting opportunity.
The primary function of the Geriatric Psychiatrist is to provide direct clinical care in the inpatient setting to geriatric patients. The program provides comprehensive inpatient mental health treatment in a positive and supportive environment.
The Psychiatric Nurse Practitioner at Unity Center for Behavioral Health provides mental health care in an inpatient setting.
- Conducts psychosocial evaluations of patients/families and significant others including, but not limited to the following: adjustment to medical or health condition; care coordination; mental health status; adjustment/compliance to treatment process; substance usage; child and elder abuse/neglect assessments; domestic violence issues; cognitive status (including potential guardian issues); and patient/family resources.
- Provides crisis intervention and supportive short term counseling to patients/families and significant others as necessary to meet immediate psycho-social needs including, but not limited to: Trauma/Emergency Department/ On Call/ Family Notification, CODE Response (family intervention); unanticipated change in health conditions/suicidal ideation; teenage pregnancy; single parent pregnancy/parenthood, domestic violence, child and elder abuse/neglect.
- Provides grief/loss counseling and education regarding: fetal demise; actual/pending death of patient//family member; complicated pregnancies; postpartum depression; chronic/acute stress associated with life circumstances; divorce/separation; loss of independence associated with illness or disability.
- Provides brief psychotherapy including: individual short term psychotherapy; group work including information/support groups, family support, patient therapy); regarding but not limited to issues of adoption, abortion , domestic violence, family of origin, sexual/gender, substance abuse, parenting, relationship adjustment to disabilities and chronic or acute illness.
- Provides patient advocacy and associated services to patient/family and other involved agencies/parties regarding decision-making; advance directives; ethics consultations; court holds; guardianship/conservatorship; citizenship cases; and social cultural factors.
- Assess patient/family support needs regarding: transportation, housing, clothing and educational/patient vocational rehabilitation and training materials and refer to appropriate resources.
- Maintains accurate and timely documentation of patient care activities an efficent manner per departmental policies.
- Participates in Department of Care Management and assigned service meetings, in services and conferences, as indicated including Complex Patient Interdisciplinary Rounds.
- Provides support to patient care staff following traumatic events through individual or group consultation.
- Reviews literature on pertinent patient care/Social Work service issues and conducts in services regarding psycho social patient care issues and Social Work services.
- Meets in regularly scheduled supervisory sessions.
- Participates in patient rounds as appropriate. Complete all OHSU/DNV mandatory education requirements and activities within established time lines.
- Yearly competencies as identified by department.
The Staff Psychiatrist will provide patient care in an inpatient setting. This is a unique opportunity for a creative, energetic psychiatrist to treat, teach and advance their academic interests.
The appointee shall provide services as assigned by the supervisor in furtherance of the university’s missions and goals of teaching, research, patient care, outreach and public service.
Academic rank begins at the level of Assistant Professor and may be higher, depending on credentials. This posting is being used to fill multiple positions.
Provides Customer Service Coordination
- Dialogues with customers regarding requests for services, supplies or equipment needs
- Conducts needs assessments and collects all pertinent/required data from customers
- Investigates, research and problem solves custom and complex requests from patient care services departments, as well other hospital divisions
- Provides information and explains standardization policies and procedures to hospital and clinic customers
- Clarifies urgency of requests and prioritizes requests based on need and lead time
- Responds to customer’s inquiry regarding status of outstanding requests
- Serves as an organizational resource to patient care services departments and other hospital divisions in regard to obtaining necessary goods and services to support patient care.
Works with Vendors: Quotes, Facilitate Trial Orders and Training
- Requests quotes, trial supplies/equipment and coordinates training schedules
- Collaborates with vendors and OHSU contracts office to ensure quotes contain appropriate contract language and discounts
- Facilitates requisitioning, receiving, staging and delivery of trial supplies and equipment
- Assists Department Managers in the planning and development of equipment training schedules for inpatient nursing units
Requisitioning and Inventory Tasks
- Requisitions special order supplies and minor/capital equipment utilizing computerized purchasing system
- Maintains and tracks special order supply inventory for all hospitals and clinics
- Collaborates with Logistics and Nurse Managers on coordination of special order additions to current inventory management system
- Tracks and reports capital and minor equipment expenditures to Patient Care Services and Clinical Technology Services Directors
- Coordinates requisitioning, receiving, staging and delivery of equipment and supplies for construction, remodel and nursing unit move projects
- Coodinates requisitioning, receiving, staging and delivery and necessary work orders for bulk buy capital equipment for hospital and clinics
- Coordinates requisition, receiving, staging and delivery of special events goods and services for hospital wide recognition events
- Coordinates the editing, proofing, printing and distribution of administrative forms, business cards and lab coats
- Identifies and processes billing; investigates and resolves discrepancies with nursing units and Logistics warehouse
- Maintains, updates and tracks membership/users to Nursing Procurement and Staples online ordering system
- Coordinates the review of goods and services contracts between the OHSU contracts office and hospital and clinic managers
- Consistently demonstrates accountability and responsibility for the day-to-day operations of the OHSU HRBR Clinic.
- Develops business and clinical flows that facilitate patient satisfaction and maximize efficiency.
- Keeps current on all clinical and business systems and ensures that staff is current as well.
- Works closely with staff, providers and other leaders to maintain and improve quality of clinical operations to ensure high quality of care and maximize cost effectiveness.
- Oversees the provider schedules; collaborates with Medical Director to ensure provider coverage across all sites at all times.
- Responsible for keeping all providers and staff and associated Practice Leaders in all sites apprised of program performance.
- Ensure workflow is in concert with system developments.
- Develops intra-departmental policies, procedures and guidelines that align with the OHSU Policies and goal.
- Participates in Service Line, Operations meetings, Division, Organizational, and Community meetings when requested.
- Keeps informed of all licensure, regulatory and safety requirements. Ensures department and staff compliance with CMS regulations,
HIPAA, OSHA, CLIA, OHSU, the Nurse Practice Act compliance, DNV and other regulations.
- Utilizes data to forecast capacity & demand as well as problem solves with data teams to ensure accurate data is used for decision making.
- Demonstrates collaborative problem-solving skills and conflict resolution. Provides daily “rounding/huddle” and will be accessible, available, and responsive to staff, providers and patients.
- Builds collaborative network and partnerships with
ancillary departments and other departments across OHSU as well as partnerships within the local community.
- Possesses the ability to act as back-up for clinically robust practice.
- Understands the procedure for medical emergencies, code 99 and other emergency/disaster situations.
Staff Management/Human Resources/Education/Training
HRBR includes an interprofessional clinical team of physicians, Advanced Practice Providers, Care Transitions Coordinators and peers with lived experience in recovery, and a non-clinical staff that includes Patient Access Specialist.
- Facilitates recruitment, interviewing, hiring, and orientation of new employees. Evaluates clinical staff supporting outpatient clinical operations. Composes and revises job descriptions as needed.
- Addresses and coordinates staff training needs; supervisors to develop standards and ensure basic competencies for all staff. Supports supervisors in identifying potential problem areas, developing a system for objectively monitoring performance, and creatively seeking solutions to foster quality improvement.
- Provides leadership, education, guidance, and professional development to direct reports and supports supervisors to provide to their direct reports.
- Continuously optimizes staff roles and responsibilities to meet performance goals.
- Responsible for grow conversations. Provides guidance and performance feedback regularly. Proactively follows-up on future plans for action.
- Revises, supports, and evaluates staff roles, taking into consideration skills, scope of practice, patient and practice needs, and core competencies.
- Makes onboarding, coaching and disciplinary decisions (per union contract, and OHSU standards).
- Supports supervisors in establishing work schedules and monitoring work performance, staffing assignments, vacation and leave approvals, as well as time and attendance system. Ensures that schedules and assignments are made and adjusted based on sick calls, special patient needs, special assignments and training.
- Supervises workloads, and monitors employee productivity.
Reviews, monitors and submits timely overtime reports.
- Ensures staff compliance with clinical competency, licensure, and scope of practice. Cultivates staff development by utilizing internal and external resources.
- Ensures that staff attends mandatory competency and training sessions.
- Maintains current knowledge of all labor contracts as required. Collaborates with Labor Relations and HR in resolving staff issues and interpreting the contracts.
- Manages budgets and cost control clinical services and grant-funded initiatives.
- Collaborates with the Department’s Administrative Director for Finance on key financial aspects of the practices such as forecasting revenue and budgeting expenses.
- Partners with payers (e.g. CCOs) to support case-rates and other revenue streams.
- Optimizes revenue through close coordination with the Professional Billing Office on billing and collection for services.
- Works with Director of Operations/finance and Medical Director to manage budget.
- Collaborates with leadership on key financial aspects of the practices such as forecasting revenue and budgeting expenses.
- Works with leadership to ensure support of case-rates and other revenue streams.
- Optimizes revenue through close coordination with the Professional Billing Office on billing and collection for services.
- Manages the implementation, evaluation, reporting, and finances for any state, federal, and private grants.
- Partners with grant managers to support pre-and post-award research administration.
- Monitors grant opportunities and manage submission of grant applications.
Coordinate & Support Interprofessional Educational Activities
- Provides administrative oversight to addiction medicine fellows, residents, and students rotating on HRBR and in collaboration with operational lead on IMPACT
- Supports efforts to balance clinical and educational missions and priorities
The teacher assistant (TA) will provide help teaching DS1s and DS2s in restorative dentistry courses. The TA will be guided by the course director and will teach along with faculty instructors to a group of designated students in the simulation clinic. They will provide feedback to students on dental procedures including but not limited to waxing, preparing teeth, restoration teeth, making provisionals, Axium, and treatment planning. They are expected to communicate with course director, show up on time, and follow course director¿s guidance. They will dedicate a maximum of one-half day a week for teaching. Teacher assistants will not be involved with student assessments. Monitor evening/Saturday Sim clinic practice sessions. Provide feedback to students on dental procedures Expected to communicate with course director Show up on time Follow course directors guidance Dedicate a maximum of one-half day a week for teaching.
Hiring Bonus and Relocation Package Available
The OHSU Clinical registered nurse (RN) provides compassionate, evidence-based, and efficient care to individuals, families, communities and patient populations. The Clinical RN's care delivery is consistent with the Oregon Nurse Practice Act, the ANA Scope and Standards of Practice, and the ANA Code of Ethics. The Clinical RN demonstrates the professional role obligations of scientist, leader, and knowledge transferor [Onsomble Model of the Professional Role™]. Professional accountability enriches the Clinical RN's engagement as a leader in promoting an inter-professional culture of collaborative decision-making, innovation, life-long learning, and teamwork. The Clinical RN exemplifies the principles of a Culture of Safety by committing to a Just Culture, a Reporting Culture, a Learning Culture, and an Engaged Informed Culture.
The PED is responsible for assessing patient needs, planning and coordinating interventions and consultations. Procedures and treatments provided in the PED include but are not limited to: placing venous access, portacath access, drawing bloodwork, medication, fluid and blood administration, radiography, extremity splinting and reduction, laceration repair, moderate and deep sedation, ultrasonography, intubation, cardioversion, pediatric sexual assault and abuse exams, and cardiopulmonary resuscitation. Patient population and diagnoses vary from minor to critical care and include: abdominal pain, extremity injuries and trauma, possible VP Shunt failure, overdose, seizure, dehydration, heart failure, respiratory distress, acute stroke, acute depression/psychological emergencies, neutropenic fever, sepsis, and other complex medical histories. The PED Team works determine if the patient requires admission or discharge with resources and referrals. The nurse-to-patient ratio is 1:1 or 1:5 based on the patients dynamic stability and acuity.
Instruction of medical students and house staff in the incumbent’s area of expertise, participates in the administration of the department as approved by the department chair.
The HEALthy Brain and Child Development (HBCD) Study at OHSU is conducting studies with pregnant people and their children in the areas of neurodevelopment, behavior, learning, environmental factors, substance exposure, and cognitive functioning under the direction of Principle Investigators, Alice Graham, Ph.D., Elinor Sullivan, Ph.D. and Bonnie Nagel, Ph.D. We have an opening for an energetic and highly motivated full-time Senior Clinical Research Assistant.
The incumbent will be responsible for neuroimaging data collection and processing for the HBCD study, involving pregnant and postpartum people and their infants and young children. The study includes neuroimaging, biological sample collection, questionnaire measures and behavioral observations. This individual will be primarily involved in the neuroimaging aspects of the study, including data collection, quality assurance, and transfer. In this role, they will assist in overseeing other staff, volunteers and graduate students involved in these areas. They will interface with personnel at the imaging center on a regular basis. They will also play a role in organizing data and supporting computing needs of HBCD study staff, volunteers and students. They will communicate with HBCD consortium members responsible for MRI data quality, transfer and processing at the consortium level. This position will require adopting a flexible schedule, with evening and weekend hours for data collection. Research aims are subject to change and therefore priority in duties may change over time.
Clinical Activities (not related to teaching or research):
- Plans and supervises student lab and/or clinical experiences or practice based on teaching assignments.
Scholarly Activities (research/writing, abstracts, grant-supported work, presentations, etc.):
- Participates in scholarly activities based on faculty rank.
- At the Assistant Professor rank or higher, faculty in the practice mission, demonstrates competence in an area of clinical expertise and engages in inquiry and scholarship that contributes to the practice of clinical practice.
- At the Assistant Professor rank or higher, faculty in the research mission advance a program of research, prepares grants and seek funding, and engage with other missions to foster inquiry within the SON.
Education Activities (include types of teaching and types of students taught):
- Provides effective didactic instruction based on teaching assignments using appropriate instructional technologies to ensure that course outcomes are met.
- Participates collaboratively in the development, implementation, and evaluation of curriculum.
- Mentors and advises students.
- Faculty in the doctoral program supervise students in dissertation and/or clinical inquiry projects.
- These activities could include faculty meetings, committee membership, professional activities, and other responsibilities as assigned by the Program or Academic Director.
- Participates in faculty governance; additional engagement based on rank.
- As negotiated.
- The appointee shall provide services as assigned by the supervisor in furtherance of the university’s missions and goals of teaching, research, patient care, outreach, and public service.
Business Advice and Contracts:
- Provide business and transactional legal advice to OHSU in support of academic, health care, and research missions and activities. Services will include provision of legal advice to health system concerning business issues, coordinating with Risk Management. Provide legal services relating to university contracting for various contracting departments. Work includes assistance in developing and modifying prototype agreements, and advice and assistance to contracts officers on the whole spectrum of contract services (affiliation agreements, student training agreements, physician or department services agreements, special relationship agreements, residency programs, acquisition of service support agreements (e.g. air ambulance), temporary health care services agreements, software and equipment agreements or licenses; and professional and construction contracts related to facilities.
- Provide legal services relating to health care regulatory matters regularly faced by an academic medical center that includes an integrated health care delivery system, including HIPAA and patient confidentiality generally, patient consent, EMTALA, medical/ legal ethics, etc. Provide legal services relating to health care regulatory issues as they relate to business transactions and relationships in the health care system. Work includes provision of advice and assistance to health system compliance staff.
- Serve as back up to primary public records attorney in the delivery of legal services relating to requests for public records.
Centralized Managed Care and Insurance Verification
- Review incoming referral orders to assess patient’s needs based on diagnosis, insurance coverage or lack thereof, and previous treatments. Referrals may be received internally via Epic or externally via fax or other methods.
- Verify patient information including demographics, insurance coverage and financial status. Confirm patient eligibility for health care coverage and clarify any managed care arrangements. Document any details related to liability insurance (i.e. motor vehicle accident, personal injury, or worker’s compensation) to determine third party liability.
- Obtains benefit information including current eligibility, deductible or co-pays, co-insurance, stoploss or out of pocket status, authorization requirements, PCP referral requirements, days approved (for routine admissions), and correct billing address.
- Document information based on department protocols in the Epic Referral shell.
- Work closely with referring providers to obtain necessary insurance referrals and authorizations.
- For urgent/emergent admissions, provides admit information and sets up authorizations and/or PCP referrals. Contacts care- management to provide clinical review and obtain length of stay.
- For routine admissions, confirms that the authorizations and/or PCP referrals cover the designated admission. If authorizations and/or PCP referrals are not noted in the system, contacts the Managed Care Coordinator from specialist’s office requesting the admission for follow up with the designated insurance company.
- Send notification of admission for urgent admissions.
- When appropriate, obtain authorizations for all clinical care, procedures, diagnostic studies, medications, outpatient infusion treatment, and inpatient admissions including notifying insurance upon admission.
- Follow up on all pending authorizations and/or PCP referrals until accounts are secured.
- Maintains current information on managed care insurance plans and serves as a liaison and information resource for patients, referring physician offices, and other OHSU staff. Applies problem solving and negotiating skills in resolving patient concerns and managed care related issues.
- Collects detailed information of trauma admissions (motor vehicle accident, personal injury, and/or worker’s compensation) to determine accident-related liability.
- Appropriately codes insurance plans in EPIC system for billing purposes.
- Work directly with insurance companies, the denial coordinator and the clinical staff and/or provider to supply necessary information to appeal denied claims and/or authorization requests as applicable
- Appropriately code insurance plans within EPIC system for billing purposes.
- Provide backup support for other Managed Care coordinators within the Centralized Managed Care & Price Estimates department.
- For self-pay patients, complete duties associated with financial assistance determinations such as above/below the line. Including connecting patients with necessary social work or financial counseling to assist in the coverage process.
- Complete necessary forms prior to upcoming procedures, admissions, and/or appointments (i.e. Non-Covered Charges Form (NCCF), Advanced Beneficiary Notification (ABN) or Patient Financial Estimate (FE)) as required.
- Work directly with the patients and clinical team to ensure patient is knowledgeable and understands their insurance benefits and/or financial obligations.
Patient Liability Estimates:
- Review work queue for patients that need an estimate created
- Document information based on department protocols in the Epic referral shell
- Create a Patient Liability Estimate
- Complete accurate pre-registration via phone as applicable
- Contact the patient prior to service to inform them of their estimate and collect any pre-payments at that time.
- Always promotes the mission of the Knight Cardiovascular Institute through our Professional Standards of Customer Service, Reliability, Productivity, Professionalism, Accuracy, Timeliness, and Problem-Solving.
- Responsible for many aspects of clinical trial management from startup to closeout and assuring appropriate conduct of protocols to FDA guidelines.
- Responsible for elements of patient visits.
- Responsible for the oversight of all trials that fall within their section.
- Assist the Clinical Trial Manager and Team Leads with other research related projects and administrative/office related duties as needed.
- Independently lead partnerships, from scouting opportunities to managing relationships;
- Facilitate and foster relationships to advance OHSU research and innovation;
- Act as first point of contact for partners seeking to collaborate with OHSU;
- Engage key department personnel and faculty to maintain positive working relationships and efficient processes;
- Appropriately anticipate and address issues that arise with partnerships.
- Oversee, manage and track all aspects of projects, including timelines, milestones, legal agreements, compliance and regulatory requirements, finances, and information flow.
- Identify and engage OHSU units as contributors to projects as needed.
- Responsible for managing communications and timelines;
- Report to stakeholders and solicit feedback during the evaluation process of partnering opportunities;
- Understand the scientific, technical and operational viewpoints of diverse stakeholders, both within OHSU and our external partners;
- Be aware of new innovations and understand technologies and their real-world commercial applications;
- Work closely and collaboratively with OHSU Technology Transfer and other programs with business-development type functions embedded within different groups at OHSU.
- Take notes at meetings and perform appropriate follow up and action items.
- Lead programs and events that allow industry participation for collaboration and measure outcomes, including helping to setup industry visits and partnering events.
- Be the primary contact with OHSU groups such as ITG, EdComm, Events and Protocol, etc. to ensure that meetings are organized appropriately and run smoothly.
This position requires the ability to work remotely, and the ability to frequently report to the OHSU Portland campus for scheduled and ad hoc meetings and assignments.
The laboratory of Brian Scottoline at the Pape Family Pediatric Research Institute, Oregon Health and Science University, Portland, OR is seeking a research assistant to help with our exciting work delineating biological functions of human milk beyond nutrition. In conjunction with the adjacent and collaborating laboratory of Sarah Andres we are interested in discovering the effects of and mechanisms for human milk in promoting intestinal epithelial and gut-associated immune system function.. We are looking for dynamic, organized, self-starters with a bachelor’s degree to help us make new discoveries. Experience in a lab setting with molecular and/or cell biology, cell culture, imaging, and conducting experiments are desired, along with an inquisitive and creative mind. You will get training and experience with cutting edge molecular biology techniques, -omics data and approaches, imaging techniques, and more. You will apply these techniques to identitfy components of human milk that modulate and drive iintestinal epithelial development and function using novel patient-derived enteroids and unique patient-derived samples. An interest in biomedical research, post-graduate training, and acquiring research-related skills is desired. Our translational research bridges the divide between basic mechanistic research and patient care. In addition to basic research skills training, our team prioritizes career development. Come learn and discover with us!
- Process incoming/outgoing faxes (labeling, records requests, upload refill requests, etc.) Scanning
- Process Inbasket (records requests, labs, imaging, message routing, etc.)
- Patient paperwork management (questionnaires, FMLA, provider signatures, no-show letters, etc.)
- Track and stock patient paperwork and brochures
- Process incoming/outgoing mail · Use of Microsoft Office—Outlook
- General high level clerical and project support
- Document legibly, concisely and accurately
- Basic rooming to include only vitals, including social history, pain (no med reconciliation, allergies)
- No medication related activities allowed (reconciliation, administration, preparation)
- Support providers during procedures but not able to perform independent clinical functions such as dressing removal/application, suture/staple removal, apply topical medications, etc.
- Technical support (MyChart, Epic, office equipment, etc.)
- Attends staff meetings/huddles
- Inventory management including equipment—notifying appropriate personnel when cleaning and repair of equipment is needed
- Instrument and scope pre-clean and processing pick up/drop off
- Check expiration dates for medications/supplies
- Turn over rooms/cleaning/stocking
- Maintains knowledge of life safety, patient safety, fire and electrical safety and disaster plan
- Sentact duties/compliance
- Monitors patient flow
- Updates patient on delays
- Provides excellent customer service
- Addresses in-the-moment patient needs as directed
- Maintains clean, safe, and orderly environment for patients, family, and clinical personnel
- Review clinical documentation of services to be coded in EPIC, and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services (CMS).
- Assign correct CPT, ICD-10-CM, and HCPCS codes for facility and/or professional charges, which could include E&M services; diagnostic services; procedural services; facility services; and/or Charge Routers and Charge entry.
- Establish and maintain procedures and other controls necessary in carrying out all procedure and diagnostic coding and insurance billing activity for applicable work queues assigned in facility and/or professional services at OHSU.
- Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical Assistance program (OMAP).
- Coordinate all billing information and ensure that all information is complete and accurate.
- Ability to maintain supportive and open communication with coding supervisor and team leads regarding coding issues and priority coding responsibilities assigned.
- Develop and disseminate written procedures to facilitate and improve billing and coding processes for the department, and to train, support, orientate, and mentor coding staff as necessary.
- Serve as a resource to ERC outpatient coding leadership and coding team for a broad range of billing policy and procedure issues.
- Attends coding meetings and seminars and shares knowledge with other coders. Participates in EC Huddles.
- In collaboration with Enterprise Coding Leadership, develop and disseminate written procedures to facilitate and improve biling and documentation processes.
- In collaboration with Leadership, make recommendations and implement remedial actions for problems
- Monitor coding and billing information from newsletters, memos, and transmittals from coding publishers and government agencies to advise physicians of billing practice changes in CPT, ICD-10-CM,and HCPCS
- Participate in Enterprise Coding education sessions, Kaizen events, maintain CEUs, stay informed of current trends in coding.
Perform other duties as assigned.
The OHSU Clinical registered nurse (RN) provides compassionate, evidence-based, and efficient care to individuals, families, communities, and patient populations. The Clinical RN's care delivery is consistent with the Oregon Nurse Practice Act, the ANA Scope and Standards of Practice, and the ANA Code of Ethics. The Clinical RN demonstrates the professional role obligations of scientist, leader, and knowledge transferor [Onsomble Model of the Professional Role™]. Professional accountability enriches the Clinical RN's engagement as a leader in promoting an inter-professional culture of collaborative decision-making, innovation, life-long learning, and teamwork. The Clinical RN exemplifies the principles of a Culture of Safety by committing to a Just Culture, a Reporting Culture, a Learning Culture, and an Engaged Informed Culture.
The HPB Nurse Coordinator (RN) is a key member of a multi-disciplinary patient care team, which includes providers, residents, fellows and support staff. The RN will provide direct and indirect professional nursing care for patients referred for Hepatopancreatobiliary surgical evaluation. They assess patient and family needs, assists in developing and implementing a plan of care, covers triage, educates, and evaluates the care delivered. The RN Coordinator serves as a key communication link between the patient and the care team. The RN Coordinator is a continuous advocate for patients and their families, ensuring that clinical and business systems are customer service focused.
- Submit bills that comply with all appropriate regulations, managed care contracts to third party payors.
- Calculate the correct reimbursement of all managed care claim
Third party follow-up and collection:
- Within the stratified processing environment, collect assertively and proactively money due OHSU by contacting (through telephoning, emailing, and/or accessing on-line systems) third parties (insurance carrier, various government programs, etc.)
- Provide explanation of charges and additional requested information to the third parties.
- Analyze accounts to determine coordination of benefits, refunds, and denials to insure appropriate resolution of accounts.
- Review billing to determine medical records necessary to provide complete processing of claim.
- Analyze accounts with regard to billing and payment history and use judgment to determines appropriate follow-up action based on departmental guidelines
- Contact patient/guarantor to resolve issues (includes tracing and locating patient/guarantor by telephoning and/or sending written correspondence.)
- Analyze accounts and interpret contracts that dictate how claims should be paid and process adjustments consistent with contract interpretation.
- Comply with special billing and follow-up requirements regarding adoptions, court holds, motor vehicle and personal injury accidents, and other unique or sensitive accounts.
- Provide data of denied claims to the Coordinator or Management for trending and reporting to the department and other partners.
- Work closely with admitting, care management and ambulatory services on the denied claims for resolution and feedback purposes.
- Prepare appeals for selected denials
Coordination of Benefits
- Analyze accounts for coordination of benefits.
- Serves as a secondary Coordination of Benefits Liaison for the Medicare Team. Performs research and analysis to determine the correct order of payers on an account. Utilizes the Medicare Common Working File (CWF), MSP questionnaire responses, employment status, other payer eligibility information and communication with the patient, employer, payers and other appropriate organizations and individuals to determine the correct order.
- Updates all affected patient accounts and clearly documents all contacts, communcation and reasons for any decision to change or not change the order the of the payers.
Other duties as assigned