Patient Account Rep 1

OHSU is Oregons only public academic health center. We are a system of hospitals and clinics across Oregon and southwest Washington. We are an institution of higher learning with schools of medicine nursing pharmacy dentistry and public health and with a network of campuses and partners throughout Oregon. We are a national research hub with thousands of scientists developing lifesaving therapies and deeper understanding. We are a statewide economic engine and Portlands largest employer. And as a public organization we provide services for the most vulnerable Oregonians and outreach to improve health in communities across the state.

As the Patient Account Rep 1 you will be resposible for billing process adjustments collect on accounts and/or perform customer service duties to ensure that moniesdue University Hospital are secured and paid in a timely manner and the AR outstanding days of revenue arekept to a minimum. Assignment will be flexible depending on payor mix patient flow and workloadfluctuations.

Third party followup and collection:

• Within the stratified processing environment collect assertively and proactively money due OHSU by contacting (through telephoning emailing and/or accessing online systems) third parties (insurance carrier various government programs etc.
• Provide explanation of charges and additional requested information to the third parties.
• Analyze accounts to determine coordination of benefits refunds anddenials to insure appropriate resolution of accounts.
• Review billing to determine medical records necessary to provide complete processing of claim
• Analyze accounts with regard to billing and payment history and uses judgment to determines appropriate followup action based on departmental guidelines
• Contact patient/guarantor to resolve issues (includes tracing and locating patient/guarantor by telephoning and/or sending written correspondence.
• Analyze accounts and interpreting contracts that dictate how claims should be paid and processing adjustments for contract interpretation.
• Comply with special billing and followup requirements regarding adoptions court holds motor vehicle and personal injury accidents and other unique or sensitive accounts
• Work reports of denied claims to trend and report these claims to the department and to our front end partners
• Work closely with admitting care management and ambulatory services on the denied claims for resolution and feedback purposes
• Prepare the appeals for selected denials

Billing

• Submit bills that comply with all appropriate regulations managed care contracts to third party payors.
• Calculate the correct reimbursement of all managed care claims

• Two years of recent (within the last 5 years) experience billing or collecting healthcare accounts in a business office;OR
• Four years of general collection billing or customer service experience; OR
• Equivalent combination of education and experience.
• Certified Revenue Cycle Specialist (CRCS) is required within 18 months ofhire.

• 1 year of recent medical collection and/or billing experience. Work experience must have occurred within five years of the date of hire.
• Recent (within one year of date of hire) Microsoft Office Suite experience in Windows environment with skill in document production using WORD spreadsheet construction in EXCEL.
• Experience in billing Hospital claims or UB04 claims.
• Knowledge of and experience in interpreting managed care contracts.
• Familiarity with DRG CPT HCPC and ICD10 coding

Job Related KnowledgeSkills and Abilities(Competencies):

• Typing 45 wpm Ability to use multiple system applications
• Demonstrated ability to communicate effectively verbally or in writing.
• Demonstrated ability to prioritize and accomplish multiple tasks in a fast paced environment; consistently adhering to defined due dates