PAS Resource Specialist at Portland, OR (Waterfront) – Portland, Oregon

Key Responsibilities & Performance Standards

Customer Service:

• Provide the highest level of customer service to both external customers (patients and their families, referring providers, insurance carriers, etc.) and internal customers (OHSU health care providers and staff) that meet or exceed 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.

Additional Business Functions/Duties / Coordination/Staff Resource:

• When called upon to do so, shares business expertise and disseminates business and clinical information to PAS Specialists within the Department. Instruct co-workers as needed in Epic. Maintains a service- based working knowledge of diagnostic and procedural coding. Provides on the job training, orientation, guidance and coaching for new PAS personnel in the service area.

Call Processing:

• Responsible for connecting the patient with the appropriate individual to progress their care in the clinic; Transfers calls to schedulers as needed, creates telephone encounters, contacts nursing coordinators, and pages providers and staff as needed per circumstance; Scheduling and managing of patient access to Center for Hematologic Malignancies Clinic; Create telephone calls from patients in the EMR which will include accurate documentation of requests for medication refills, complaints, general information inquiries and urgent health care concerns; Triage calls to the appropriate staff for patient care /needs assessment; Process call (answering, screening, routing, paging etc.) in a timely, polite, professional manner; Route calls to appropriate conclusion; Provide information to callers, including directions, addresses and hours of operation; Use schedules and departmental procedures to locate appropriate on-call person for internal and external callers; Understand and process calls per departmental policy for each encounter type (ie refill, telephone, documentation, etc).

Checkout:

• Checks out patients in person for clinic visits, procedures, and infusion appointments. This includes but is not limited to face to face complex coordination of clinic visits and treatment, a careful review of insurance benefits, demographic information, confirming insurance eligibility, and /or authorization. Checks patient account numbers and corrects any problems, seeking advice from Central Registration as required. Ensures that all appointment comment information is accurate and completed. Identifies and updates deductible payments, co-payments, and prepayment requirements. Proper use of OHSU forms and documentation of required for all patients.

Scheduling:

• Coordinate patient care appointments, procedures, and infusion treatments as directed by physician and/or nurse staff; Serves as a liaison and information resource for physicians, and nursing support staff; Return phone messages; Prepare and mail patient information packets; Direct patients to appropriate providers for other health care issues; Complete and route direct referrals to other clinical services; Enter patient information accurately into the electronic medical record when necessary. Maintains a service-based working knowledge of oncology practice.
• Is responsible for verifying patient eligibility and securing referral/authorization prior to the outpatient appointment or inpatient admission. The authorization process includes but is not limited to, putting referral information online, obtaining authorization to provide care from the insurance company, identifying how much of the patient’s deductible has been met, determining how much of an education benefit has been exhausted, tracking the number of visits used per authorized, following up on referrals for return appointments, and other miscellaneous tasks.

Integrated Care:

• Obtain prior medical records and studies when appropriate; Responsible for obtaining, recording, tracking, and verifying referrals and authorizations for the respective outpatient clinic and lab visits when necessary.

Administrative Duties:

• Faxing; Letter queues; Use right fax to send outgoing fax notification re: referral receipt; Other duties as assigned.

Continued Professional Development:

• Participate in appropriate educational activities that enhance general knowledge or ability to do assigned work; Attend staff meetings and other informational sessions; Read vendor documentation, trade publications, or other appropriate publications; interact with peers and other employees to receive and disseminate information.

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

• HS Diploma or advanced degree preferred.
• Appointment scheduling experience.
• Basic computer keyboarding skills including typing of 40-50wpm.
• Proficient computer skills including word processing.
• Extremely high level of attention to detail. Strong customer service orientation. Must have excellent verbal and written communication,listening skills and awareness of self.
• Demonstrated reliable attendance record.
• Demonstrated effectiveness in confrontational customer interactions.
• Demonstrated problem solving and negotiation skills in resolving patient concerns, scheduling challenges and managed care related problems.
• Demonstrated understanding of managed care.
• Demonstrated reliable attendance record.
• Experience in a medical and/or oncology office setting.
• Knowledge of Epic systems. Knowledge of OHSU network systems, including Outlook and Microsoft Office products