Managed Care Coordinator Pre Float (PAS Resource Specialist)

OHSU • Portland, OR

359d • Hybrid

About The Position

This position is responsible for providing administrative support for Clinical Transplant services. It is a Pre Float position that combines duties of a Referral Coordinator and Managed Care Coordinator. Orientation on site. After orientation: Hybrid position including on site and remote work.

Requirements

• One year of experience in a medical office setting, including high-volume direct patient contact, scheduling of appointments and may require experience obtaining managed care authorizations.
• One and a half years of work experience in a high volume direct public contact position and 6 months experience in a medical office setting.
• Thorough knowledge of PAS policies and procedures.
• Demonstrated advanced PAS user skills as well as extensive knowledge of integrated care at OHSU.

Nice To Haves

• High School Diploma or GED
• Prefer BS or BA in any area.
• Whole organ transplant medical office experience.
• EPIC Phoenix experience.
• Medical protocol processing experience.
• Laboratory data entry experience.
• Advanced EMR management.
• Advanced computer keyboarding skills.
• Epic Referrals & Cadence.

Responsibilities

• 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.
• 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.
• Collects from physicians all information necessary for authorizations and appeals.
• Obtains authorizations for listing and transplant surgery.
• Maintains current information regarding pre-transplant evaluation schedules for service site providers.
• 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.
• Enters all information accurately into OHSU databases or into the medical record when necessary.
• Follows up on pending authorizations until they are obtained.

What This Job Offers

• Industry: Hospitals
• Education Level: High school or GED
• Number of Employees: 101-250 employees