PAS Revenue Cycle Specialist

To support Oregon Health Sciences Universitys mission by providing exemplary service to all patients patient families visitors and staff who present to any area of Patient Access Services Department in person via telephone or over electronic communication. To greet interview register and preregister patients scheduled for hospital admission. Creates reservations for day patient and Inpatient admissions and complete InterHospital transfers. Obtains and records demographic and insurance data to ensure accurate patient identification to facilitate payment and compliance with all regulatory requirements. Performs employee requirements as outlined in Compliance Roles and Responsibilities Code of Conduct and Respect at the University for OHSU Hospital and Clinics.

Patient Registration/Interviews:

• Gathers adds updates and/or verifies detailed demographic information and completed/signed forms required for services. These functions are performed atstationary computer terminals or at patients bedside using a mobile computerterminal occasionally over the phone. Hand written documentation may only beutilized during computer downtime or device malfunction.
• Completes Race Ethnicity Language and Disability (REALD) questionnaire with patient face to face or over the phone and updates REALD Smart Form as required bylaw. Serves as liaison for patients and families with questions.
• Satisfies state regulations to identify support persons for individuals with disabilities.
• Correctly identifies patient service type to establish an accurate and billable account.
• Corrects patient identity inaccuracies as identified.
• Schedules reservations into Epic with a base knowledge of diagnoses and procedures.
• Validates appropriate admitting locations by procedure and admitting provider to ensure appropriate patient placement.
• Accurately complete InterHospital Transfers and sameday admissions and obtain prior medical records as needed.
• Activates direct admissions based on notification from unit at time of patients arrival.
• Follows Oregon Administrative Rules (OARs) regarding workers compensation in operation of OHSU and industry workmans compensation procedures. Provides timely follow up for completion of workmans compensation 827 and DOLI form for work related injuries.
• Initiates and completes claims for workers compensation injuries personal injury motor vehicle accidents and crime victim accounts.
• Provides patient education regarding OHSU financial assistance insurance coordination of benefits Patient Rights Terms & Conditions Advance Directives Medicare Secondary Payer Questionnaire Medicare and Commercial notices of Non Covered services (ABN or NCCF) Important Message from Medicare Release of Information Special Consent Champus Message to patients and their representatives Notice of Privacy Practices use of patient information and/or specimens in OHSU research and other facility or regulatory documents.
• Obtains signatures and enters into computer all facility and regulatory required data and forms. Reviews all for accuracy.
• Responsible for all identity management corrections after hours.
• Identifies and collects copays deductible payments deposits and prepayments for services as required.
• Provides receipts and completes necessary accounting procedures including reconciliation and deposit of funds.
• Creates and assembles Patient Packets as required for Hospital @ Home or other admitting areas.
• Determines urgent/emergent medical situations and activates rapid response team or engages the assistance of nursing staff to assist.
• Manage patient valuables process; may maintain safe/valuables audit monthly.
• PreRegistration: Gathers adds updates and/or verifies detailed demographic information including REALD and support persons prior to admission by calling the patient at home. Searching for patient information in a number of online databases including EPIC.
• Follow and complete daily task list as assigned by management.
• Required to maintain Patient Access Services Individual Performance Standards which includes:
• Production Standard: Meets individual standard determined by shift of PAS work activities/completed registrations per day.

Insurance Verification/Financial Clearance:

• Gathers adds updates and/or verifies detailed insurance coverage and financial status with each patient over the phone or face to face.
• Creates new and maintains existing insurance coverages/guarantors for a patient based on their insurances and the care being provided.
• Obtains benefit information including deductible or copays coinsurance stoploss or out of pocket status and correct billing address.
• Complete insurance verification on each patients insurance 100% of the time when the insurance verification status says New Elapsed Incomplete Needs Review or is Medicaid using electronic verification in RTE payer portals or other required methods. The PAS Revenue Cycle Specialist staff will also reverify the eligibility insurance information if the insurance was not verified in the current month.
• Reviews MMIS for all uninsured or single coverage patients
• Refers all nonsponsored patients to Oregon Health Plan (OHP) and provides information for financial assistance working closely with Financial and Medicaid Services.
• Ensures all required forms are completed for services and confirmation of payment sources.
• As required notifies payors of admissions to OHSU Facilities for patients that are treated in the Emergency Department facilitytofacility transfers for higher level of care or direct admissions.
• Maintains current information on managed care insurance plans and serves as a liaison and information resource for patients referring physician offices and other OHSU staff. Applies problem solving and negotiating skills in resolving patient concerns and managed care related issues.
• Maintain knowledge pertaining to insurance issues which include but are not limited to motor vehicle Workers Compensation personal injuries Medicare OHP/Washington Welfare/Medicaid and exposures.
• Responsible for securing and explaining authorization for usage of Medicare Lifetime Reserve Days.
• Maintain knowledge pertaining to insurance issues which includes but is not limited to motor vehicle workmans compensation personal injuries Medicare OHP/Washington Welfare/Medicaid and exposures
• Collects detailed information of trauma admissions (motor vehicle accident personal injury and/or workers compensation) to determine accidentrelated liability.
• Maintain access to all insurance website by signing in one time per month at minimum.

• High School diploma or equivalentAND
• One year of experience in a medical office setting including highvolume direct patient contact scheduling of appointments and registration and/or billing responsibilities. OR
• Two years of work experience in a highvolume direct public contact frontline nonhealthcare setting position.

Knowledge and Skills Required:

• Basic computer skills including word processing and Windows applications.
• Basic computer keyboarding skills including typing of minimum 40 wpm.
• Demonstrated working knowledge around insurances and benefits.
• Demonstrated excellent verbal and written communications skills.
• Strong customer service orientation.
• Demonstrated effectiveness during extremely confrontational customer interactions in a high stress environment.
• Demonstrated advanced PAS user skills or equivalent as well as extensive knowledge of integrated care models.

• Prior experience in hospital admissions or ED registration.
• Minimum six months experience as a registrar at OHSU and demonstrated accuracy rate of 97% or greater. As a registrar must be meeting/exceeding all other individual performance standards in a sustained manner.
• Thorough knowledge of verifying medical insurance including workers comp and third party liability

Knowledge and Skills

• OHSU Registration experience.
• Demonstrated efficiency and problem solving in resolving patient concerns.
• Strong attention to detail and processes.
• Ability to work with a high level of accuracy speed multitask and prioritize in high stress/high volume environments with little direct supervision.
• Demonstrated record of reliable attendance punctuality and proven successful performance at past and present employers.
• Demonstrated effective interpersonal skills which promote cooperation and team work.
• Actively seeks conflict resolution between coworkers seeking assistance if needed.

Hours of Work: Shift assigned based on position posting. Admitting is open all days of the year including holidays from

5:00am9:00pm Monday Friday and 6:00am9:00pm S/S. Position may work weekends and holidays depending on department need.

Temperatures can vary and staff should be prepared to layer to accommodate for personal comfort.

Locations are:

• South Hospital 9th Floor
• Doernbecher Childrens Hospital 8th Floor
• Multnomah Pavilion 4th Floor
• Casey Eye Institute 6th Floor
• All inpatient units on Marquam Hill Campus

Benefits:

• Two raises per year One at anniversary date and one across the board annual increase
  
• Healthcare Options Covered 100% for fulltime employees and 88% for dependents and $25K of term life insurance provided at no cost to the employee
  
• Two separate above market pension plans to choose from
  
• Vacation up to 200 hours per year depending on length of service
  
• Sick Leave up to 96 hours per year
  
• 8 paid holidays per year
  
• Substantial Trimet and CTran discounts
  
• Additional Programs including: Tuition Reimbursement and Employee Assistance Program (EAP)