PAS Resource Specialist
PAS Resource Specialist
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Department Overview
The PAS Resource Specialist is responsible for assuring that appointments and ordered services will be covered by the patients insurance or if uninsured the patient is referred appropriately to obtain necessary support. The PAS Resource Specialist provides managed care services for the work unit by providing excellent customer service through prompt and professional communication skills occasional facetoface customer contact skills and excellent problem solving skills. The PAS Resource Specialist also works with patients to help them to understand their insurance benefits and payment obligations.
Function/Duties of Position
- Verifies insurance eligibility and obtains benefits referrals/prior authorizations and documents in patients file.
- Updates insurance information on patients accounts when applicable.
- Reviews orders and documents treatment approvals and locations in patients record (EMR).
- Monitors all treatment regimens for insurance coverage and appropriateness of indication and forwardto Manager/Formulary Committee for approval as needed.
- Maintains offsite log or assists peers with maintenance by obtaining authorizations for ancillary service referrals and documentation of such.
- Applies problem solving and negotiating skills in working with insurance companies and referring providers to obtain a successful outcome.
- Performs financial counseling with patients prior to treatment and calculates coinsurance amounts as requested or obtains costs of treatment for ABN preparation.
- Functions as a point of inquiry and resource for all work unit staff with questions regarding insurance coverage and where scans and treatments may be done.
Required Qualifications
- One year of experience in a medical office setting including highvolume 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.
Job Related Knowledge Skills and Abilities (Competencies):
- Basic computer skills including word processing. Windows applications online scheduling and a preference for database skills.
- Excellent verbal and written communications skills.
- Strong customer service orientation.
- Demonstrated effectiveness in confrontational customer interactions.
Preferred Qualifications
Education:
- High School Diploma
- Associate Degree or higher
- Minimally some college coursework in related field
Experience:
- 3 years of experience in medical clinic business office (insurancerelated) operations or with insurance company
- Prior managed care experience including insurance verification referral coordination and/or financial counseling with customer service functions
- Knowledge and understanding of various payer programs and drug assistance programs
- Experience in working with chemotherapy in medical oncology setting
- Knowledge of computer applications including Epic Cadence EARL ARIA
Additional Details
- This position works in a busy office environment with multiple competing demands; frequent interruptions and interpersonal interactions with both internal and external customers.
- This position is for 10 hour shifts Sunday Wednesday after initial training is complete.
- During training the shift will be Monday Friday 8:305.
- Position requires employee to have vehicle and travel occasionally between the various offices of the OHSU Community Oncology work unit.
All are welcome
Required Experience:
Unclear Seniority
Employment Type
Full-Time
