Oregon Health & Science University Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu. PAS Revenue Cycle Specialist US-OR-Portland Job ID: 2024-31395 Type: Regular Full-Time # of Openings: 1 Category: Hospital/Clinic Support Portland, OR (Waterfront) Overview
Patient Registration/Interviews:
Gathers, adds, updates, and/or verifies detailed demographic information and completed/signed forms required for services. These functions are performed at stationary computer terminals, occasionally over the phone or at beside with paper forms and/or a tablet. Hand written documentation may only be utilized during computer downtime or device malfunction.
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. 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.
Schedules reservations into Epic with a base knowledge of diagnoses and procedures.
Validates appropriate admitting locations by procedure and admitting provider to ensure appropriate patient placement.
Provides patient education regarding OHSU financial assistance, insurance coordination of benefits, Patient Rights, Terms & Conditions, Advance Directives, Medicare Secondary Payer Questionnaire, Medicare and Commercial notices of Non-Covered services (ABN or NCCF), Important Message from Medicare, Release of Information, Special Consent, Champus Message to patients and their representatives, Notice of Privacy Practices, use of patient information and/or specimens in OHSU research, and other facility or regulatory documents.
Obtains signatures and enters into computer all facility and regulatory required data and forms. Reviews all for accuracy.
Responsible for all identity management corrections after hours.
Identifies and collects co-pays, deductible payments, deposits, and prepayments for services as required.
Creates and assembles surgical patient intake form packets for the surgical floors
Determines urgent/emergent medical situations and activates rapid response team or engages the assistance of nursing staff to assist.
Follow and complete daily task list as assigned by management.
Required to maintain Patient Access Services Individual Performance Standards which includes:
Production Standard: Meets individual standard determined by shift of PAS work activities/completed registrations per day.
Error Rate Standard: Maintain an accuracy rate of 97%.
Co-Pay and Prepayment Rate Standard: Maintain a collection rate of 80% or better, and maintain a POS Payment standard work of 95% or better
Customer Service: 2 or fewer validated customer service complaints in any rolling one year period. Must follow the OHSU Model of Communication in 100% of customer interactions and consistently demonstrate exemplary internal and external customer contact skills.
Enrollment & Authorization:
Gathers, adds, updates, and/or verifies patient information including detailed demographics, detailed insurance coverage/benefits, MyChart enrollment, and financial status with each patient over the phone or face to face.
Creates new and maintains existing insurance coverages/guarantors for a patient based on their insurances and the care being provided.
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, stoploss or out of pocket status, and correct billing address.
Complete insurance verification on each patient’s insurance 100% of the time when the insurance verification status says New, Elapsed, Incomplete, Needs Review, or is Medicaid, 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
Refers all non-sponsored patients to Oregon Health Plan (OHP) and provides information for financial assistance, working closely with Financial and Medicaid Services.
Ensures all required forms are completed for services and confirmation of payment sources.
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.
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.
Maintain knowledge pertaining to insurance issues which includes but is not limited to motor vehicle, workman’s compensation, personal injuries, Medicare, OHP/Washington Welfare/Medicaid, and exposures
Maintain access to all insurance website by signing in one time per month, at minimum.
Centralize Check-In Operations:
Complete training and maintain competency in Event Signaling and Event Signaling workflows.
Understand and uphold the mission and vision of a centralized check-in modeled building.
Assist in educating other OHSU employees on the standard workflows and patient flows of a centralized check-in modeled building.
Actively collect and report abnormalities to further improve the centralized check-in model.
Troubleshoot situations where patients are out of flow.
Maintain competency in tools, technology, online portals and programs essential to completing day to day standard work responsibilities (Epic Cadence, Epic Grand Central, Epic Prelude, Microsoft Office, payment collection devices, printers, phones, copy/fax machines, OnBase, Solarity Scan, Vocera, paging system, parking validation, etc.).
Scheduling walk-in appointments for partnering practices per standard work.
Responsibilities
High School diploma or equivalent AND
One year of experience in a medical office setting, including high-volume direct patient contact, scheduling of appointments and registration and/or billing responsibilities. OR
Two years of work experience in a high-volume direct public contact, front-line non-healthcare setting position.
Knowledge and Skills Required:
Basic computer skills including word processing and Windows applications.
Basic computer keyboarding skills including typing of minimum 40 wpm.
Demonstrated working knowledge around insurances and benefits.
Demonstrated excellent verbal and written communications skills.
Strong customer service orientation.
Demonstrated effectiveness during extremely confrontational customer interactions in a high stress environment.
Demonstrated advanced PAS user skills or equivalent as well as extensive knowledge of integrated care models.
Ability to walk and stand for 6-8hours a day, position is extremely mobile.
Actively seeks conflict resolution between co-workers, seeking assistance if needed
Must have demonstrable customer service skills both over the phone and face to face.
Must be detail oriented, highly accurate and able to multi-task in high volume situations.
Must have demonstrable record of reliable attendance, punctuality, and proven successful performance at past and present.
Must be able to work independently with little direct supervision.
Must be able to recognize problems and proactively solve or correct them.
Qualifications
Prior experience in medical office front desk and high patient volume.
Experience with Epic
Knowledge and experience in Microsoft OneNote.
Knowledge of PAS procedures and integrated care at OHSU preferred, and/or completion of a PAS Trainee program.
Knowledge and Skills
Knowledge of Epic systems.
Knowledge of OHSU network systems, including Outlook and Microsoft Office products.