This position is responsible for managed care processes within Revenue Cycle Operations. The Revenue Cycle Operations managed care coordinator is an integral part of the RCO team by providing clear and accurate information regarding our patient's financial obligations related to their visits, treatments, and/or inpatient admissions. This position will work closely with the Ambulatory Access Service Intake Coordinators, Clinical staff, and RCO leadership to ensure patients receive optimal services related to their care. This position serves as a member of the Revenue Cycle Operations department, which is responsible to support the systems and operations of ambulatory practices, professional service and hospital departments. The incumbant will have an extensive knowledge of Managed Care processes in the ambulatory and inpatient setting included but not limited to insurance eligibility, benefits verification and authorization requirements. He/She is knowledgeble about the Epic system and current best practice referral and prior authorization workflows. The incumbant is able to provide support and backup to the Revenue Cycle Operations Department as needed for cross-coverage for all managed care workflows within the departemnt.
At least one year of experience in a medical office setting in a managed care position, including high-volume scheduling of appointments, multi-line phone system, medical terminology and obtaining managed care authorizations.
The candidate must have a thorough knowledge of managed care policies and procedures, as well as authorization and referral processes in EPIC.
Candidates will have demonstrated advanced managed care user skills.
Experience with electronic scheduling, managed care websites and electronic medical record systems.
Advanced computer skills, including MS Word, Excel and Access, OHSU Epic skills and online resource use knowledge.
Excellent communication skills, both written and verbal Demonstrated knowledge of managed care policies and procedures including appropriate timelines, paperwork, regulations, communication and follow-up are also required.
Demonstrated efficiency, problem solving and negotiation skills in resolving patient concerns and managed care related problems.
Must meet Department performance standards measuring efficiency, production, timeliness and accuracy.
This will be reviewed on a regular basis both as a team and as an individual.
Ability to multi-task in a high volume situation.
Strong attention to detail and processes
Ability to work autonomously, with a high level of accuracy, speed and exhibit a willingness to work with deadlines.
High School Diploma or GED
OHSU Experience preferred.
Excel skills and knowledge preferred.
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 email@example.com.
As the state's only health and research university, OHSU brings together patient care, research, education of the next generation of health care providers and scientists and community service to improve the health and well-being of all Oregonians.The university is a conduit for learning for more than 2,800 students, providing training to interns, residents and fellows in postgraduate medical and r...esearch. It is the only place in Oregon that grants doctoral degrees in medicine, dentistry and nursing. OHSU cares for more than 251,000 patients each year from around the region and takes a leadership role in contributing to solutions involving the health of the state and the nation, such as health care access and transparency, ethics and workforce shortage. Beyond providing critical health care services, quality education and cutting-edge research, OHSU also is a key economic and social force in the Northwest. With an annual operating budget of $2.06 billion and more than 14,000 employees, OHSU is Portland?s largest employer. Its size contributes to its ability to provide many services and community support activities not found anywhere else in Oregon. For more information visit http://www.ohsu.edu/xd/about/index.cfm