Managed Care Coordinator Pre Float (PAS Resource Specialist)

OHSU-posted 12 months ago
Hybrid • Portland, OR
101-250 employees
Hospitals
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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.

  • 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.
  • 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.
  • 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.
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