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 firstname.lastname@example.org.
PAS Resource Specialist
# of Openings:
Portland, OR (Marquam Hill)
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.
- Schedules new patient appointments. Obtains prior medical records and studies if appropriate. Creates medical records 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.
- Arranges clinical, diagnostic, or laboratory services; obtains authorizations when necessary. Directs patients to appropriate providers for other health care issues. Routes direct referrals to other clinical services. Contacts primary care physicians or their designees to obtain authorizations for urgent care. Schedules return appointments; initiates authorization requests for subsequent care. Enters and tracks lab results as needed.
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 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, while considering fiscal impact. Applies problem solving and negotiating skills in resolving patient concerns and managed care related problems.
- Inputs external laboratory results into Epic.
- 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.
- 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. OR
- 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.
- The candidate must have a thorough knowledge of PAS policies and procedures.
- Candidates will have demonstrated advanced PAS user skills as well as extensive knowledge of integrated care at OHSU.
Knowledge and Skills Required:
- Basic computer skills including word processing.
- Windows applications, on-line scheduling, and a preference for data-base skills.
- Excellent verbal and written communications skills.
- Strong customer service orientation.
- Demonstrated effectiveness in confrontational customer interactions.
- Organ transplant medical office experience.
- Knowledge of OHSU system software including EPIC, Phoenix, and electronic eligibility systems