PAS Resource Specialist/ Managed Care Coordinator/ Surgery Scheduler Details

PAS Resource Specialist/ Managed Care Coordinator/ Surgery Scheduler

Oregon Health & Science University - Portland, OR

Employment Type : Full-Time

Department Overview:

The School of Dentistry shares the mission of the Oregon Health & Science University to provide educational programs, basic and clinical research, and high quality care and community programs. We strive to foster an environment of mutual respect where the free exchange of ideas can flourish. The dental school prepares graduates in general dentistry and the dental specialties to deliver compassionate and ethical oro-facial health care.

Read more about the School of Dentistry: http://www.ohsu.edu/xd/education/schools/school-of-dentistry

Function/Duties of Position:

The Hospital Dental Services (HDS) PAS Resource Specialist (Surgery Scheduler/Managed Care Specialist) is primarily responsible for the coordination of managed care insurance and special patient group processes.

The PAS Resource Specialist acts as guidance for PAS Specialists and other staff in the areas of health care contract terms, complex patient referrals, and other managed care issues. This position is also responsible for managed care authorizations for all consultations, procedures, office visits and care arrangements.

This position is responsible for knowing HDS clinic policies including but not limited to appointment scheduling, payments, and insurance, and must be able to communicate these policies with patients, students, faculty, and staff. 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.

The PAS Resource Specialist will provide assistance in the use of the PAS network software. Experience with OHSU network applications, to include workqueues, the referral shell, Cadence, and viewing of Resolute preferred. An understanding of access CIM/MMIS for both medical and dental coverage is preferred. This position performs in a manner which maintains the confidentiality and privacy of each patient, promotes positive health habits through appearance and attitude. Supports and adheres to the Code of Conduct and Policies and Procedures of both OHSU Hospital and clinics and Hospital Dental Services; models ethical and appropriate behavior, professional standards, compliance and personal integrity; adheres to the rules and regulations of CMS and DNV standards.

Required Qualifications:

• One year of experience in a medical office setting, including high-volume direct patient contact, scheduling of appointments and obtaining managed care authorizations
• Must have a thorough knowledge of PAS policies and procedures
• Demonstrated advanced PAS user skills as well as extensive knowledge of integrated care at OHSU
• Experience with general practice, oral maxiofactial, and/or pediatrics
• Experience with electronic scheduling, managed care and documentation systems (referrals, authorizations)
• Demonstrated exceptional customer service
• Experience with high volume multi line phone system
• Basic computer skills, including MS Word and Excel, knowledge of Windows applications
• Excellent customer service skills, including verbal and written communications skills
• Demonstrated knowledge of managed care intricacies including appropriate timelines, paperwork, regulations, communication and follow-up are also required
• Working knowledge of managed care and referral and authorization processes
• Demonstrated problem solving and negotiation skills in resolving patient concerns, scheduling challenges, and managed care related problems
• Demonstrated reliable attendance record
• Working knowledge and understanding of medical terminology
• Ability to multi-task in a high volume situation
• Ability to problem solve and retain pertinent information
• Professional appearance and demeanor required
• Must be able to share office space with other coworkers and able to multi-task in a high-volume clinic
• Must be able to sit long periods of time, as well as spend 80% of time on telephone usage
• Must be able to perform the essential functions of the position with or without accommodation

Preferred Qualifications:

• 1 year of customer service experience in a PAS Resource Specialist/Surgery Scheduling position

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.