PAS Resource Specialist

Oregon Health & Science University•Portland, OR

23h•Hybrid

About The Position

The PAS Resource Specialist works in the Department of Urology at OHSU, which provides adult and pediatric urology care and contributes to research and the training of future urologists. The role provides high-quality customer service to patients, families, referring providers, insurance carriers, OHSU clinicians, and staff. It supports managed-care and financial-clearance processes by verifying patient and guarantor information, checking coverage and benefits, clarifying managed-care arrangements, obtaining and tracking authorizations, recording information in EPIC Cadence and EARL, and helping resolve authorization and enrollment denials. The specialist also determines and arranges collection of payments due at the time of service, supports required patient forms, communicates and documents inquiries and messages, and serves as a resource on insurance authorization requirements. The position is hybrid and generally works business hours from 8:00 a.m. to 5:00 p.m.; occasional early or late hours may be needed for patient or physician needs and staff meetings.

Requirements

One year of experience in a medical office setting, including high-volume direct patient contact and appointment scheduling; experience obtaining managed-care authorizations may be required depending on the position description; OR one and a half years of work experience in a high-volume direct public-contact position and six months of experience in a medical office setting.
Thorough knowledge of PAS policies and procedures.
Demonstrated advanced PAS user skills and extensive knowledge of integrated care at OHSU.
Proficiency with managed-care functions, including eligibility issues, authorizations, referrals, and time-of-service payments and collections.
Basic computer skills, including word processing; familiarity with Windows applications and online scheduling.
Excellent verbal and written communication skills.
Strong customer-service orientation and demonstrated effectiveness in confrontational customer interactions.
Ability to work independently with little direct supervision.
Demonstrable record of reliable attendance, punctuality, and successful performance at past and present employers.
Ability to work general business office hours from 8:00 a.m. to 5:00 p.m., with occasional early or late hours to accommodate patient or physician needs and staff meetings.

Nice To Haves

Bachelor’s degree or some college experience.
Two years of experience in a high-volume medical office.
Experience in a urology service.
OHSU PAS experience.
EPIC experience.
Database skills are preferred.

Responsibilities

Provide professional, timely customer service to patients and families, referring providers, insurance carriers, OHSU health care providers, and staff.
Use customer-service, crisis-management, complaint-processing, and process-improvement skills to address customer needs and concerns.
Gather and verify patient and guarantor demographic, insurance, and financial information.
Confirm eligibility and benefits with insurance carriers using electronic databases, phone, fax, or email, and clarify managed-care arrangements.
Obtain authorizations for clinical care, surgeries, procedures, and laboratory studies; accurately enter authorization, referral, and benefit information into EPIC Cadence and EARL.
Follow up on pending authorizations and work with the manager to resolve authorization- or enrollment-related denials in a timely manner.
Attend monthly managed-care meetings and share relevant information with staff.
Serve as a liaison and information resource for physicians, nursing support, coworkers, and referring physicians regarding insurance authorization requirements.
Determine payments due at the time of service, including copayments, coinsurance, deductibles, deposits, and prepayments, and arrange for collection.
Arrange completion of T&C forms and NCCF forms and submit them as appropriate.
Use problem-solving and negotiation skills to resolve patient concerns and managed-care problems.
Follow up on UMG denials as requested by the manager and perform other tasks related to OHSU managed-care processes.
Communicate with internal and external customers using Epic, phone, Teams, and other means; document information accurately and route messages, information requests, urgent health concerns, and general inquiries to the appropriate source.

Benefits

Healthcare coverage for full-time employees paid 100% by the employer and 88% for dependents.
$50,000 of term life insurance provided at no cost to the employee.
Choice of two pension plans described as above market.
Vacation of up to 200 hours per year, depending on length of service.
Sick leave of up to 96 hours per year.
Nine paid holidays per year.
Substantial Tri-Met and C-Tran discounts.
Employee Assistance Program.
Childcare service discounts.
Tuition reimbursement.
Employee discounts to local and national businesses.