Job Description

Department Overview:

The Division of Plastic and Reconstructive Surgery provides innovative, quality care for cosmetic and plastic surgery needs while simultaneously training surgeons to become experts in the field. Its faculty are specialists in their practice, including breast reconstruction, hand surgery, pediatric cleft and craniofacial surgery, gender affirming surgery and microsurgery. The team of plastic surgeons sponsors a six-year integrated plastic surgery residency program, a hand surgery fellowship program and, together with the Department of Urology, a gender surgery fellowship program.

This position will provide weekend support for the managed care team. Expertise in all higher level clinical functions including eligibility screening, managed care verification, authorization acquisition, procedure scheduling (clinical, outpatient and inpatient), and communication with insurance companies for the resolution of claims denials. This employee will be responsible to provide coverage for vacations and terminations but also augment current staffing when work levels indicate. This position requires an expert level understanding of all PAS-R and managed care roles within the nine division of the Department of Surgery. This employee is responsible for maintaining a current knowledge base of clinical function standards as defined by Ambulatory Services, ASA MCC Services, and Department of Surgery management.
Function/Duties of Position:
Customer Service - Provides high quality customer service to both external customers (patient, referring providers, and insurance carriers) and internal customers (OHSU health care providers and staff) that meets or exceeds the service standards of the health care industry. This duty includes prompt and professional communication efforts, face-to-face customer contact skills, crisis management, facility with available information, technology, standard complaint processing, flexible coverage of internal service needs, and the continuous application of process improvement methods and skills. Project Support-This position will support unfinished ongoing projects that can not be accomplished during the normal business week. Surgery Managed care and Surgery scheduling. Confirm surgery benefit and obtain authorization for surgery and procedures in clinic. Work with Surgery Program Coordinator to schedule port cases and other surgeries as determined by Surgery Program Coordinator. Clinical Operations Monitoring - Investigates claim denials, at the direction of the Revenue Cycle Manager, to provide feedback on process improvement and denial resolution. Other - May be asked to complete special projects relating to clinical operations within the Department of Surgery.

Required Qualifications:
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 (dependent on position description). 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.

Preferred Qualifications:
Completion of MCC course with access to insurance websites. Surgery scheduling. EPIC appointment scheduling, usage of DAR reports and knowledge of insurance websites. Regular and reliable attendance

Additional Details:
Monday - Friday. 8AM-4:30PM. This position works in a busy environment with many interruptions, multiple demands and interactions. This position will handle a high volume of patient phone calls, high level of multi tasking, and scheduling. Extensive keyboarding and multi-line phone system usage.

All are welcome: 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 aaeo@ohsu.edu.