Managed Care Coordination –

• Maintains current information on managed care insurance plans and serves as a liaison and information resources for physicians, nursing support staff, PAS specialists, referring physician offices, patients, Hospital Operations Support and others on authorization requirements; serves as a service area resource ICD9 coding requirements; obtains managed care authorizations for consultations, procedures, office visits, care arrangements, and contact other ancillary and clinical services as needed; problem solves and negotiates skills in resolving patient concerns and managed care related problems.

Radiology/Surgery Scheduling -

• Schedules multifaceted patient appointments on line, and manually if necessary in all modalities of Diagnostic Imaging Services. Maintains current information regarding schedules for resources and providers. Serves as liaison and information resource for physicians, nursing support staff, coworkers, IP Admitting Department, Surgery Office, and Periop Services.
• Collects from physician and clinics all information necessary order information to schedule a scan (including ICD9 codes, diagnosis, equipment needs, etc.).
• Facilitates care arrangements by scheduling IRU time, preops, PAT clinic, ancillary and clinical services as needed. Applies problem solving and negotiating skills in resolving provider and patient concerns and other imaging related problems.

Customer Service -

• Provide high quality customer service to both external customers (patients, referring providers, clinics, insurance carriers) and internal customers (OHSU health care providers, staff) that exceed the service standards of the health care industry.
• This duty includes prompt and professional communication efforts, face-to-face and telephone customer contact skills, crisis management, familiarity with available information technology, standard complaint processing, flexible coverage of internal service needs, and the continuous application of process improvement methods and skills.

Enrollment & Authorization -

• Gather and/or verify patient information including demographics, insurance coverage, and financial status.
• Confirm patient eligibility for health care coverage and clarify any managed care arrangements.
• Verify appropriate accounts are active and associated with services to be received.
• Confirm authorizations for imaging procedures. Enter all information accurately into OHSU databases or into the medical record when necessary. Follow up on pending authorizations until they are obtained.

Other Duties as Assigned

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.
• Must be able to perform the essential functions of the position with or without accommodation
  

• Associates degree.
• 2+ years in a medical office setting.
• Experience in a radiology office setting strongly preferred.
• Database skills.
• RIS, EPIC systems.
• Radiology specific medical terminology.