The Patient Access Specialist’s purpose is to positively promote the Oregon Health & Science University (OHSU), Department of Medicine, and the Harold Schnitzer Diabetes Health Center in a friendly and professional manner.    Front-line patient contact: - Greeting and checking patients in and out; answering phones, sorting mail; faxing, photocopying, and filing documents/records; typing correspondence; gathering patient information; screening for financial eligibility; managing clinic templates; confirming health care coverage; obtaining referrals; scheduling appointments in person and over the phone; and assisting patients in a clinical setting.  This position directly supports the Department of Medicine’s objectives of service excellence, clinical care, and quality assurance.

Customer Service: - Provide the highest level of customer service to both external customers (patients and their families, referring providers, insurance carriers, etc.) and internal customers (OHSU health care providers and staff) that meet or exceed the service standards of the health care industry. 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. Scheduling: - Coordinate patient care appointments, procedures, and infusion treatments as directed by physician and/or nurse staff; Serves as a liaison and information resource for physicians, and nursing support staff; Return phone messages; Prepare and mail patient information packets; Direct patients to appropriate providers for other health care issues; Complete and route direct referrals to other clinical services; Enter patient information accurately into the electronic medical record when necessary. Maintains a service-based working knowledge of oncology practice. - Is responsible for verifying patient eligibility and securing referral/authorization prior to the outpatient appointment or inpatient admission. The authorization process includes, but is not limited to, putting referral information on-line, obtaining authorization to provide care from the insurance company, identifying how much of the patient’s deductible has been met, determining how much of an education benefit has been exhausted, tracking the number of visits used per authorized, following up on referrals for return appointments, and other miscellaneous tasks. Checkout: - Checks out patients in person for clinic visits, procedures, and infusion appointments. This includes, but is not limited to face to face complex coordination of clinic visits and treatment, careful review of insurance benefits, 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 updates deductible payments, co- payments, and prepayment requirements. Proper use of OHSU forms and documentation required for all patients.

- Provide 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. This duty includes prompt and professional communication efforts, primarily as a phone operator and scheduler, facilitate with available information technology, standard complaint processing, flexible coverage of internal service needs, and the continuous application of process improvement methods and skills. - Gather and/or verify patient information including demographics, insurance coverage and financial status. Enter all information accurately into OHSU databases and scheduling system. Scheduling of Departmental and ancillary appointments per guidelines and protocol. - Triage and document accurately telephone calls from patient including requests for medication refills, complaints, general information inquiries and urgent health care concerns. Facilitate retrieval of required information and delivers such information or requests promptly per Departmental protocol. - Cross train and cover other PAS Specialist positions as needed. Complete successfully the required PAS initial training and core competency assessment before and during the trial service period. Complete all required update modules. Maintain core competencies and demonstrate continuous application of these skills through the period of employment. Other duties as assigned.

- Provide high quality customer service to all internal and external customers. This includes communicating accurately, openly, supportively, in a timely manner, and extending special attention and sensitivity to all patients, visitors, and fellow employees. - Assist in maintaining an atmosphere of cooperation within the department, as well as with other departments and allied professionals.  - Demonstrate respect and cooperation in all staff relationships, and a genuine willingness to prevent or resolve inter-personal conflicts. Must demonstrate superior face to face customer contact skills, remain calm and resourceful during crisis management or other difficult situations, and manage standard complaint processing. - Required to learn and maintain skill with available information technology, and remain current with changes to departmental procedures and new information. - Reviews financial application and attached documentation submitted by patients to determine that all required information is provided and is completed properly. For any incomplete applications, returns with letter of explanation outlining incomplete information or lacking verification documents. Requests and reviews additional documentation of financial information regarding ability to pay, eligibility, or financial allowances. Provides information, clarification, and interpretation of financial policy and procedure to assist patients in completing the financial application and understanding the basis for decisions made. - Analyzes applications with regard to supportive documentation, Oregon residency rules, account history, and determines action based on departmental guidelines in conjunction with income inclusion and exclusion criteria.  - Assigns liability percent based on assessment and documents on the registration computer system for hospital and physician practice billing services. Mails a letter of approval with financial allowance information to the applicant, or mails a letter of denial of allowance if patient did not qualify for a discount. - Refers those patients who show potential elgibility for Oregon Health plan or Washington Medicaid to contact internal Financial & Medicaid Specialist group to assist with the application process. - Notifies billing office of the retroactive assignments of any approved financial allowance.   - Assures that the financial application, verification documents and Liability Determination Worksheet have been scanned into the document imaging system. - Maintains a database on the information and disposes of originals using the confidential recycling bin. - Gather and/or verify patient information including demographics, guarantor, emergency contacts, insurance coverage, and financial status when applicable. - Verify patient eligibility for health care coverage and enter appropriate insurance plan information accurately. Provide financial screening for low income or non-sponsered patients and refer patients to Medicaid programs or send a charity care application when appropriate.

- Provides high quality customer service to both external customers and internal customers that meets or exceeds the service standards of the health care industry. This duty includes prompt and professional communication efforts, exemplary phone etiquette, flexible coverage of internal service needs, and continuous follow through. - Gathers and/or verifies patient information including demographics, insurance coverage, and financial status. Confirms patient eligibility for healthcare coverage and clarifies any managed care arrangements. Obtains authorizations for clinical care, procedures and laboratory studies. Enters all information accurately into OHSU database or into the medical record when necessary. Follows up on pending authorizations until they are obtained - Schedules new and return patient appointments on line. - Is responsible for all processes involved in checking patients in and out. Responsible for but not limited to scheduling return appointments, scheduling ancillary services as requested by the provider, obtain authorization when necessary. Directs patients to appropriate providers for other health care issues. Completes and routes direct referrals to other clinical services. Contact Primary Care physicians or their designees to obtain authorizations for care as required. Is responsible for managing all of the provider’s template changes, vacations and clinic schedules. - Takes accurate messages from patients including request for medication refills, complaints, general information inquiries, and urgent healthcare concerns. Delivers such information or requests promptly to the appropriate providers, Nurse Care Manager or their designees.

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. 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.

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. This duty includes prompt and professional communication, 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 Telecommunications: - Triages and documents accurately telephone calls from patients including requests for medication refills, complaints, general information inquiries, and urgent health care concerns. Delivers such information or requests promptly to the appropriate providers or their designees. Point of Service Operations: - Front desk duties include greeting patients and confirming that an appointment has been kept. Inspects insurance cards and/or authorization notices. Identifies and collects deductible payments co-payments, and deposits on services; provides receipts and completes necessary accounting procedures. - Verifies and updates the common data set on-line. Explains and satisfies any necessary patient signature requirements.  - Checks out patients to ensure all appointments for follow up are appropriately scheduled and communicated properly. Coordinating any necessary studies, scans, testing, or combined department visits as necessary. - Opening/Closing duties may include wiping down the patient lobby, emptying recycling, scanning documentation into EPIC, removing papers from clinic areas (HIPAA), cleaning up work spaces and other administrative duties as assigned. Arranged Care: - Schedules new patient appointments on line and manually if necessary. - Creates a medical record if needed. Obtains and prepares OHSU medical records before scheduled appointments. - Arranges stretchers, wheelchairs, and interpreters when necessary, and accommodates other special needs whenever possible. - Mails information packets. Provides personal reminders to patients about upcoming appointments. 

The purpose of this position is to be responsible for the specimen receipt and accessioning aspects of a commercial laboratory. Duties include order entry, verification of specimens, coordination of specimen pick-up and delivery, and specimen tracking. This position also provides customer supplies, requisitions, and reports, and participates in troubleshooting and process improvement.   The Specimen Processing Specialist 2 provides specific customer services that include: registration and accessioning using LIS and Epic, transcription using word processing and speech dictation applications, coordination of authorizations for care with managed care, maintain materials control system in Dermatopathology custody, and assisting patients and referring physicians in the office of Dermatopathology. This position is responsible for technical (ICD-10 and CPT coding) and administrative work (transcription and data entry) and training other Specimen Processing Specialists. - Registration and Accessioning. Responsible for receiving specimens and associated requisition paperwork. Assigns unique accession number; enters patient and specimen information from requisition slip into databases as required (EPIC, ULTRA/GGG, Tamtron, LabDirector/4D) for clinical service, proficiency testing and research specimens. Follows proper accessioning procedures for specimens. Initiate calls to health care providers to clarify orders, referring physicians, requesting location or patient history. Log, label and distribute specimens, requisitions, and patient files. Distribute specimens to appropriate lab or pick up area, notifying lab supervisors of special requests or circumstances. Coordinate local courier pickup and delivery from OHSU and FedEx from outreach clients. Track missing specimens and resolve discrepancies quickly with documentation and communication to lab and/or client. Ship Styrofoam specimen shippers to clients on request and document inventories. Maintain proper documentation to meet CLIA, CAP and legal standards. Follows guidelines for proper patient confidentiality per HIPPA. - Act as registration point by gathering and/or verifying patient information including demographics, and insurance coverage. Use Lab Information System and Epic as pivot point for distribution of demographic, referral, clinical, and pathology-resulting data to multiple sources, including OHSU Medical Group and referring physicians. Transcribe from dictation or written word in to a variety of hospital and departmental applications, verifies correct ICD10 and CPT codes for billing. Reviews Dermotopathology billing workques for accuracy and make changes as necessary. Act as resource to PAS Specialists and Office Assistants in correct Dermatopathology office procedures and policies. - Process special notation, slides and other correspondence under direction of Dermpath Manager and Director of Dermatopathology and send to external customers and clients. - QC Tracking. Maintain materials control system to identify location of every block and slide in Dermatopathology custody. Maintain accurate filing system. Package and send materials and documents to referring clients and reference points. - Order and Data Entry. Arrange and order associated clinical, diagnostic or laboratory services, coordinate authorizations when necessary. Direct patients to appropriate providers for other health care issues. Complete and route direct referrals to other clinical services. - Customer Service. Provide high quality customer service to both external customers (patient, referring providers and insurance carriers) and internal customers (OHSU health care providers and staff) that meet or exceed the service standards of the health care industry. This duty includes prompt and professional communication efforts, face-to-face customer contact skills, and crisis management, facilitate available information technology, standard complaint processing, flexible coverage of internal service needs, and the continuous application of process improvement methods and skills. Triage and document accurately telephone calls from patients and providers including complaints, general information inquiries and urgent health care concerns. Deliver such information or requests promptly to the appropriate providers and manager. - Point of Service Operations. Speaks with patients and providers/offices over the telephone to confirm slide readings and specimen referrals. Inspects insurance and authorization information. Verifies and updates common insurance data in Epic system. - Training. Provides on the job training, orientation, guidance and coaching for new specimen processing specialists. Is expected to share expertise with less experienced staff. May be asked to perform in a lead capacity. - Administrative Duties. Generate add-on requisition slips at the request of the client or Medical Director, which includes coordinating and documenting client approval. Set up new clients in appropriate databases. Copy, sort, mail and/or fax final reports upon request to appropriate customer locations. Prepare case folders for lab workflow as required. Maintain workflow statistics for quality assurance. Receive, sort, and deliver incoming and outgoing mail and requests for information. Maintain printers and copiers in front office and arrange for service as necessary. Review requisitions for completion of all necessary information for correct testing, interpretation of results and billing. Contact clients as needed to obtain missing information. Follow clean claims process for billing services for technical and professional fees. - Distribution of Data. Facilitate mail, send, receive and categorize faxes, email and other correspondence. Coordinate mail distribution with other departmental employees.

- Provide 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. This duty includes prompt and professional communication efforts, primarily as a phone operator and scheduler, facilitate with available information technology, standard complaint processing, flexible coverage of internal service needs, and the continuous application of process improvement methods and skills. - Gather and/or verify patient information including demographics, insurance coverage and financial status. Enter all information accurately into OHSU databases and scheduling system. Scheduling of Departmental and ancillary appointments per guidelines and protocol. - Triage and document accurately telephone calls from patient including requests for medication refills, complaints, general information inquiries and urgent health care concerns. Facilitate retrieval of required information and delivers such information or requests promptly per Departmental protocol. - Cross train and cover other PAS Specialist positions as needed. Complete successfully the required PAS initial training and core competency assessment before and during the trial service period. Complete all required update modules. Maintain core competencies and demonstrate continuous application of these skills through the period of employment. Other duties as assigned.

This is an In-person Position NOT available for remote work.   Customer Care: - Provides high quality customer service to both external and internal customers that meets or exceeds the service standards of the health care industry. - Demonstrates knowledge of all department, locations, units, and buildings on OHSU campus. - Promptly greet all patient and visitors in a warm professional manner whether face to face or over the phone. This includes providing directions and screening all patients and visitors. - Determine customer needs proactively and direct inquires to appropriate resources. - Provide crisis management and conflict resolution as issues arise whether internal or external. Arrange Care: - Functions as a liaison for families during complicated cases by working with the clinical team, social worker, and case managers. - Arranges any and all accommodations needed to provide the best experience to all our customers. This includes mobility equipment (wheelchairs, stretchers, Etc.), interpreter services, and identifies support services for individuals with disabilities, when necessary, in compliance with State regulations. - Mails information packets. Enrollment & Financial Services: - 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. This includes but not limited to: Providing patient education regarding OHSU financial assistance, insurance coordination of benefits, and other facility or regulatory documents. - Maintain knowledge pertaining to insurance issues which include but are not limited to motor vehicle, Worker’s Compensation, personal injuries, Medicare, OHP/Washington Welfare/Medicaid, and exposures. - Creates new and maintains existing insurance coverages/guarantors for a patient based on their insurances and the care being provided. - Obtains benefit information including deductible or co-pays, co-insurance, stop loss or out of pocket status, and correct billing address. Collects cost-shares at time of service. - Complete insurance verification on each patient’s insurance 100% of the time. - Gathers, adds, updates, and/or verifies detailed demographic information and completed/signed forms required for services. These functions are performed at stationary computer terminalor or at patient’s bedside using a mobile computer terminal, occasionally over the phone. - Completes Race, Ethnicity, Language, and Disability (REALD) questionnaire with patient face to face or over the phone and updates REALD Smart Form as required by law. - Follows Oregon Administrative Rules (OAR’s) regarding workers’ compensation in operation of OHSU and industry workman’s compensation procedures. Also initiates and completes claims for worker’s compensation injuries, personal injury, motor vehicle accidents, and crime victim accounts by collecting detailed information of trauma admissions (motor vehicle accident, personal injury, and/or worker’s compensation) to determine accident-related liability. Authorization & Registration Services: - Validates appropriate admitting locations by procedure and admitting provider to ensure appropriate patient placement. - Accurately complete Inter-Hospital Transfers and same-day admissions and obtain prior medical records as needed. - Activates direct admissions based on notification from unit at time of patient’s arrival. - Ensures all required forms are completed for services and confirmation of payment sources. Training: - Successfully complete the required PAS Specialist and PAS Revenue Cycle Specialist initial training and core competency assessment during the initial probationary period. Maintains core competencies, and demonstrates continuous application of these skills throughout the period of employment. - Gives instruction to other PAS Revenue Cycle Specialist personnel pertaining to PAS Revenue Cycle Specialist processes and procedures as well as performance. Provides on the job training, orientation, guidance and coaching for new PAS Revenue Cycle Specialist personnel in the service area as assigned. May be required to provide informational assessment of other PAS Revenue Cycle Specialist workers’ performance to the PAS Coordinator/Supervisor and/or the employment supervisor - Required to maintain Patient Access Services Individual Performance Standards. Daily Office Tasks: - Troubleshoots equipment problems and initiates repairs requests once reviewed with leadership. - Ensures Patient Access Services Department Coordinator is aware of low forms/supply levels. - Provide coverage in other admitting areas and the Emergency Department when needed. - Follow and complete daily task list as assigned by management.

Managed Care Coordination: - Maintains current information on managed care insurance plans and serves as a liaison and information resources for physicians, nursing support staff, PAS specialists, referring physician offices, patients, Hospital Operations Support and others on authorization requirements; serves as a service area resource ICD9 coding requirements; obtains managed care authorizations for consultations, procedures, office visits, care arrangements, and contact other ancillary and clinical services as needed; problem solves and negotiates skills in resolving patient concerns and managed care related problems. Radiology/Surgery Scheduling: - Schedules multifaceted patient appointments on line, and manually if necessary in all modalities of Diagnostic Imaging Services. Maintains current information regarding schedules for resources and providers. Serves as liaison and information resource for physicians, nursing support staff, coworkers, IP Admitting Department, Surgery Office, and Periop Services. - Collects from physician and clinics all information necessary order information to schedule a scan (including ICD9 codes, diagnosis, equipment needs, etc.). Facilitates care arrangements by scheduling IRU time, preops, PAT clinic, ancillary and clinical services as needed. - Applies problem solving and negotiating skills in resolving provider and patient concerns and other imaging related problems. Enrollment & Authorization: - Gather and/or verify patient information including demographics, insurance coverage, and financial status. Confirm patient eligibility for health care coverage and clarify any managed care arrangements. - Verify appropriate accounts are active and associated with services to be received. Confirm authorizations for imaging procedures. - Enter all information accurately into OHSU databases or into the medical record when necessary. Follow up on pending authorizations until they are obtained.

- Assists in coordination of all Home Infusion referrals to ensure that all necessary information is received and available to clinician - Assists in all technical support activities relating to prior authorization requests and approvals. - Interacts with other health care team members (both internal and external) and displays a high level of customer service commitment. - Understands billing systems (both internal and external third party) and presciption processing and understands audit procedures and risk management strategies. - Communicates effectively with other pharmacy personnel at multiple locations. - Coordinates prior authorization policies and procedures with counterparts. - Assists in urgent pharmacy operations.

CUSTOMER SERVICE: - Provides high quality customer service to both external and internal customers that meets or exceeds the service standards of the health care industry. - Promptly greet all patients, visitors, and others in a warm, courteous, and professional manner -  Demonstrates the ability to communicate effectively, timely, and respectfully at all times, especially in a high stress environment. - Provides flexible coverage to assist with internal service needs and the continuous application of process improvement methods and skills. - Determines customer needs proactively, and direct inquiries to appropriate resources. - As problems and miscommunications occur with internal or external customers, demonstrates the ability to clarify and resolve problems immediately to avoid further communication breakdowns. - Demonstrates respect and cooperation in all staff relationships, with a genuine willingness to prevent or resolve inter-personal conflicts. - Answers multi-line telephone inquiries. Determine caller needs and assist callers efficiently and appropriately. - Determine priorities and act quickly, make decisions efficiently and in a calm manner in emergency and stressful situations. - Utilizes appropriate interpreter services when necessary. PATIENT REGISTRATION: - Gathers, adds, updates, and/or verifies detailed demographic information and any applicable forms. Complete registration from patient work queues, email, or inbasket as assigned. - Completes Race, Ethnicity, Language, and Disability (REALD) questionnaire with patient and updates REALD Smart Form as required by law. Serves as liaison for patients and families with questions. - Satisfies state regulations to identify support persons for individuals with disabilities. - Correctly identifies patient service type to establish an accurate and billable account. - Corrects patient identity inaccuracies, as identified. - Follows Oregon Administrative Rules (OAR’s) regarding workers’ compensation in operation of OHSU and industry workman’s compensation procedures. - Initiates and completes claim info for worker’s compensation injuries, personal injury, motor vehicle accidents, and crime victim accounts. - Provides patient education regarding OHSU financial assistance, insurance coordination of benefits, Patient Rights, Medicare Secondary Payer Questionnaire, Notice of Privacy Practices, use of patient information and/or specimens in OHSU research, and other facility or regulatory information. - Provide financial screening for low income or non-sponsered patients and refer patients to apply for Oregon or Washington Medicaid or OHSU Financial Assistance when appropriate. - Pre-Registration: Gathers, adds, updates, and/or verifies detailed demographic information, including REALD and support persons, prior to admission by calling the patient at home. Searching for patient information in a number of online databases including EPIC. - Follow and complete daily task list as assigned by management. - Provide financial screening for low income or non-sponsered patients and refer patients to apply for Oregon or Washington Medicaid or OHSU Financial Assistance when appropriate. INSURANCE VERIFICATION/FINANCIAL CLEARANCE: - Gathers, adds, updates, and/or verifies detailed insurance coverage and financial status with each patient. - Creates new and maintains existing insurance coverages/guarantors for a patient based on their insurances and the care being provided. - Complete insurance verification on each patient’s insurance using electronic verification in RTE, payer portals, or other required methods. The PAS Revenue Cycle Specialist staff will also re-verify the eligibility insurance information if the insurance was not verified in the current month. - Reviews MMIS for all uninsured or single coverage patients - Provide financial screening for low income or non-sponsered patients and refer patients to apply for Oregon or Washington Medicaid or OHSU Financial Assistance when appropriate. Works closely with Patient Financial Services on

Professionalism - Conducts oneself in an ethical and legal manner, the OHSU Code of Conduct, federal privacy policies, state statutes and OARs, and complies with hospital and departmental policies and procedures. - Manages use of time effectively to complete professional and technical tasks, within realistic time constraints. - Takes responsibility for special projects and assignments, additional workload when needed, and adapts to changing and demanding environments. - Displays mature, effective professional relationships by accepting appropriate suggestions and constructive criticism and responding with modification of behaviors and exhibiting concern for others. - Pursues continuing education opportunities, applies and shares new knowledge, participates in staff meetings and in-services. - Displays professional communication in a face to face patient interaction as well as phone conversation. Assists in the supervision and training for students and volunteers from other disciplines, including, medical assistance physical, speech therapy, audiology, medicine and nursing. Arranged Care - Schedules new patient appointments on line and manually if necessary. Creates a medical record if needed. Arranges stretchers, wheelchairs, and interpreters when necessary, and accommodates other special needs whenever possible. Mails information packets. Provides personal reminders to patients about upcoming appointments. Obtains and prepares OHSU medical records before scheduled appointments. - Enrollment & Authorization. Gathers and/or verifies patient information including demographics, insurance coverage, and financial status. Confirms patient eligibility for health care coverage and clarifies any managed care arrangements. - Greets patients and confirms that an appointment has been kept. Inspects insurance cards and/or authorization notices. Identifies and collects deductible payments, co-payments, and deposits on services; provides receipts and completes necessary accounting procedures. Verifies and updates the common data set on-line. Explains and satisfies any necessary patient signature requirements. Validates parking. Answers phone calls, returns messages, Billing, and cash handling - When requested, obtains authorizations for clinical care. Enters all information accurately into OHSU databases or into the medical record. Follows up on pending authorizations until they are obtained. Customer Service - Demonstrates excellent customer service and communication skills in all interactions with patient/clients, families, caregivers,  internal and external customers, including telephone, electronic and face to face situations. Using AIDET at all times. - Addresses complaints and problems promptly and courteously, involving management when indicated. - Communicates using active listening skills in a supportive courteous, professional manner at all times to patients/clients, family/caregivers and staff. 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. - 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.

- 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. 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. - Enrollment & Authorization: Gathers and/or verifies patient information including demographics, insurance coverage, and financial status. Confirms patient eligibility for health care coverage and clarifies any managed care arrangements. Educates patients of pre-pay amounts, monitors provider’s schedules and other managed care duties as assigned. Fills out patient financial responsibility forms when necessary. Enters all information accurately into OHSU databases or into the medical record when necessary.  - Arranged Care: Schedules New and return patient appointments and coordinates any ancillary appointments. Cross-coverage of other GS Scheduler positions that would require facilitating medical review and scheduling new patients for other GS specialties. Obtains prior medical records and studies when appropriate. Creates a medical record if needed. Monitors provider’s schedulers to fill cancellations, no-shows and records needed for each provider. Arranges stretchers, wheelchairs, and interpreters when necessary, and accommodates other special needs whenever possible. Mails information packets to patients. - File Uploading and Document Scanning: Use Media Manager software in Epic to upload documents into patient’s charts for current medical care or referral purposes. Document Scanning via Point of Care.  Requires an extremely high level of attention to detail ensuring the correct records go into the patient’s chart. - Telecommunications and Administrative Duties: Triages and documents accurately telephone calls from patients including requests for medication refills, complaints, general information inquiries, and urgent health care concerns. Delivers such information or requests promptly to the appropriate providers or their designees. Other administrative duties as assigned. - Continued Professional Development: Participate in appropriate educational activities that enhance general knowledge or ability to do assigned work; Attend staff meetings and other informational sessions; Read vendor documentation, trade publications, or other appropriate publications; interact with peers and other employees to receive and disseminate information.

Managed Care Coordination: - Maintains current information on managed care insurance plans and serves as a liaison and information resources for physicians, nursing support staff, and coworkers, referring physician offices, OHSU Health Plan Office, patients, and insurance companies on authorization requirements per diagnosis and service.  Serves as service area expert on ICD9 coding requirements and issues.  Obtains managed care authorizations for all consultations, procedures, office visits, and care arrangements by scheduling appointments and contacting other ancillary and clinical services as needed.  Applies problem solving and negotiating skills in resolving patient concerns and managed care related problems. Enrollment & Authorization: - Gathers and/or verifies patient information including demographics, insurance coverage, and financial status. Confirms patient eligibility for health care coverage and clarifies any managed care arrangements. 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. Arranged Care: -  Schedules new patient appointments. Obtains prior medical records and studies as directed by the clinical staff and Providers. Prior to patient scheduled appointment, obtains lab reports, procedure documents, CDs, on-line communications, OHSU medical records, and other medical reports from referring physicians as required by various clinical genetics subspecialties. Accommodates patient special needs such as: wheelchairs, stretchers and interpreters. Mails information packets and provides patients with pre-clinic visit information and reminders.   Telecommunications: - Triages and documents accurately telephone calls from patients including requests for medication refills, complaints, general information inquiries, and urgent health care concerns. Delivers such information or requests promptly to the appropriate providers or their designees. 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.  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.  Integrated Care: - Arranges and orders associated clinical, diagnostic, or laboratory services; obtains authorizations when necessary. Directs patients to appropriate providers for various health care issues. Completes and routes direct referrals to other clinical services. Contacts PCP or their designees to obtain authorizations for urgent care. Schedules return appointments. Initiates authorizations requests for subsequent care. Training and Competency:  - Successfully completes the required PAS initial training and core competency assessment before or during the trial service period.  Completes all required update modules.  Maintain core competencies, and demonstrate continuous application of these skills throughout the period of employment. Support and assist in the development of continuous quality improvement components of the clinical practice.  Build upon the OHSU Performance Excellence System (OPEX) to continuously improve Clinical Genetic Service. Clinical Service Resource: - Shares PAS expertise and disseminates PAS information to PAS Specialiests wihtin the service area.  Instructs co-workers as needed in user skills for PAS system software including RSS, Order Entry, LCR, EAD and the minimal and common data sets.  Maintaines a service based working knowledge of diagnositic and procedural coding.  Fills in as needed for any PAS or PASR position within the service areas.

The School of Dentistry (SOD) Patient Access Service (PAS) Specialist provides courteous and comprehensive administrative support services for patients, students,faculty, staff, and visitors at the OHSU Dental Clinics in the School of Dentistry. These duties include but are not limited to answering phones, patient registration, insurance verification, collection of payments, balancing cash drawer, answering billing questions, and other administrative tasks as assigned that support all of OHSU Dental Clinics. The SOD PAS Specialist must be able to consistently perform all the functions of the job in order to maintain excellent and comprehensive service for all the patients, students, faculty and staff.   The SOD PAS Specialist works in a high public contact area dealing with patients and staff in a positive and consistent manner. Each employee must interact with the patients, some in acute dental pain, in a friendly, knowledgable, and appropriate manner.   The SOD PAS Specialist are responsible for knowing SOD clinic policies including but not limited to appointment scheduling, payments, and insurance, and must be able to communicate these policies with patients, students, facutly, and staff. Each OHSU Dental Clinic at the SOD may have different policies specific to their department, and the SOD PAS Specialist will be required to use their judgement to implement the appropriate policy or give information specific to each situation they encounter.   The SOD PAS Specialist may be deployed to different desks, floors, or work stations throughout each day to cover areas at peak times. The SOD PAS Specialist must be flexible and be able to complete work with considerable independence on a daily basis. The SOD PAS also provide support to the Russell Street Clinic and could be deployed to work at that clinic depending on business needs.   This position provides English to Spanish and Spanish to English language interpretation. 

Customer Service:   - Provide the highest level of customer service to both external customers (patients and their families, referring providers, insurance carriers, etc.) and internal customers (OHSU health care providers and staff) that meet or exceed the service standards of the health care industry. - 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. Additional Business Functions/Duties / Coordination/Staff Resource: - When called upon to do so, shares business expertise and disseminates business and clinical information to PAS Specialists within the Department.   - Instruct co-workers as needed in Epic.   - Maintains a service-based working knowledge of diagnostic and procedural coding.   - Provides on the job training, orientation, guidance and coaching for new PAS personnel in the service area. Call Processing:  - As needed, responsible for connecting the patient with the appropriate individual to progress their care in the clinic; Transfers calls as needed, creates telephone encounters, contacts nursing coordinators, and pages providers and staff as needed per circumstance; Scheduling and managing of patient access to Center for Hematologic Malignancies Clinic; Create telephone calls from patients in the EMR which will include accurate documentation of requests for medication refills, complaints, general information inquiries and urgent health care concerns;  Triage calls to the appropriate staff for patient care /needs assessment; Process call (answering, screening, routing, paging etc.) in a timely, polite, professional  manner;  Route calls to appropriate conclusion; Provide information to callers, including directions, addresses and hours of operation; Use schedules and departmental procedures to locate appropriate on-call person for internal and external callers; Understand and process calls per departmental policy for each encounter type (ie refill, telephone, documentation, etc); As needed, expected to take 10% of incoming volume of clinic calls. Check-in/Checkout: - Checks in and out clinic, procedure, and infusion appointments.     - This includes, but is not limited to careful review of insurance benefits, demographic information, confirming insurance eligibility, and /or authorization, and complex provider and infusion scheduling.   - 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 updates deductible payments, co-payments, and prepayment requirements. - Proper use of OHSU forms and documentation required for all patients. Scheduling:  - Coordinate high volume of complicated patient care appointments, procedures, and infusion treatments as directed by physician and/or nurse staff; Serves as a liaison and information resource for physicians, and nursing support staff; Return phone messages; Prepare and mail patient information packets; Direct patients to appropriate providers for other health care issues; Complete and route direct referrals to other clinical services; Enter patient information accurately into the electronic medical record when necessary.  Maintains a service-based working knowledge of oncology practice. - Is responsible for verifying patient eligibility and securing referral/authorization prior to the outpatient appointment or inpatient admission. - The authorization process includes, but is not limited to, putting referral information on-line, obtaining authorization to provide care from the insurance company, identifying how much of the patient’s deductible has been met, determining how much of an education benefit has been exhausted, tracking the number of visits used per authorized, following up on referrals for return appointments, and other miscellaneous tasks. - Obtains managed care authorizations for all consultations, procedures, office visits, and care arrangements by scheduling appointments and contacting other ancillary and clinical services as needed. Applies problem solving and negotiating skills in resolving patient concerns and managed care related problems.  Integrated Care: - Obtain prior medical records and studies when appropriate; Responsible for obtaining, recording, tracking, and verifying referrals and authorizations for the respective outpatient clinic and lab visits when necessary.   Administrative Duties:   - Faxing; Letter queues; Use right fax to send outgoing fax notification re: referral receipt; Other duties as assigned.

Admission and Continued Stay - Deliver, explain, and obtain signature on Observation notification to patients as required by the Centers for Medicare and Medicaid Services (CMS). May include printing copy for patient if desired and scanning copy into patients chart via Epic Scanner or using tablet to obtain electronic signature. - Deliver, explain, and obtain signature on Condition Code 44 notices. Includes printing copy for patient if desired and scanning copy into patients chart via Epic Scanner or using tablet to obtain electronic signature. Hospital Discharge - Deliver to patients and obtain signature on second Medicare Important Message. Includes printing copy for patient if desired and scanning copy into patients chart via Epic Scanner or using tablet to obtain electronic signature. - Deliver to patients and scan all Detailed Notice of Discharge forms for Medicare discharge appeals. Includes making copy for pt after signed. - Schedule discharge transportation under direction of Case Manager or Care Integration Specialist (CIS) - Create packets under the direction of Case Manager or CIS Utilization Review - Provide utilization review for OHSU/DCH or AHP with the guidance of the UM PAS. - Gather and fax all paperwork for Medicare discharge appeals. - Data entry for UR Committee Case determinations, Outlier Review Meetings, and Denials Tracking Spreadsheets. - Triage denials/audits to appropriate UM Nurse. - Deliver discharge information packets to nursing units for patients transferring to other facilities.

Managed Care Coordination: - Maintains current information on managed care insurance plans and serves as a liaison and information resources for physicians, nursing support staff, and coworkers, referring physician offices, OHSU Health Plan Office, patients, and insurance companies on authorization requirements per diagnosis and service. Serves as service area expert on ICD9 and ICD10 coding requirements and issues. Obtains managed care authorizations for all consultations, procedures, office visits, and care arrangements by scheduling appointments and contacting other ancillary and clinical services as needed. Applies problem solving and negotiating skills in resolving patient concerns and managed care related problems. ECT Scheduler: - Maintains current information regarding surgery schedules for service site providers. Serves as liaison and information resource for physicians, nursing support staff, coworkers, IP Admitting Department, Surgery Office, and Periop Services. - Collects from physician all information necessary to schedule a surgery (including ICD9 codes, equipment needs, etc.). Maintains surgery information to OR as soon as received. - Starts insurance process and obtains authorizations. Facilitates care arrangements by scheduling preops, PAT clinic, ancillary and clinical services as needed. Applies problem solving and negotiating skills in resolving provider and patient concerns and other surgery related problems. Enrollment & Authorization: - Gathers and/or verifies patient information including demographics, insurance coverage, and financial status. Confirms patient eligibility for health care coverage and clarifies any managed care arrangements. - 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 Clinical Service Resource: - Shares PAS expertise and disseminates PAS information to PAS Specialists within the service area. Instructs co-workers as needed in user skills for PAS system software including RSS, Order Entry, LCR, EAD, and the Minimal and Common data sets. Maintains a service-based working knowledge of diagnostic and procedural coding. Fills in as needed for any subordinate PAS position within the service areas. Telecommunications: - Triages calls and faxes from patients, families, physicians, and pharmacies; transfers calls to appropriate provider line and/or pages information regarding cancellations and rescheduled appointments; communicates medication refills appropriately; triages consult, general information, complaints, and intake requests appropriately; communicates promptly with clinic manager any events or information pertinent to clinic operations.