PAS Resource Specialist/Pediatric Transplant

Department Overview

This PAS Resource Specialist position is responsible for providing administrative support for Clinical Transplant services as part of the Kidney/Pancreas Program. This position directly supports the pediatric transplant program & provides cross coverage support for adult transplant program. Duties include processing referrals, scheduling appointments, and coordination of admissions, office visits, lab entry, and additional testing; facilitating insurance clearance and authorizations for transplant evaluation, transplant, admissions, and other outpatient services as required; professionally documenting in a patients electronic health record; screening program related phone calls (patients, referring physicians, OHSU Staff, and insurance carriers); management of work queues to meet OHSU metric standards; frequently communicating to the multidisciplinary team; and provides assistance to patients, functioning as the liaison for insurance plans, providers, and care team members. The PAS Resource Specialist in this position is responsible for accurately managing a large volume transplant patient population. This position requires significant attention to detail, accuracy, and timeliness as many of the job functions are to meet regulatory requirements. This position is vital for the efficient operation of a complex work unit.

Function/Duties of Position

Key Responsibilities & Performance Standards

 

Enrollment & Authorization.

• Gathers and/or verifies patient information including demographics, insurance coverage, and financial status. Confirms patient eligibility for health care coverage and clarifies any managed care arrangements. Obtains authorizations for clinical care, procedures, and laboratory studies. Enters all information accurately into OHSU databases or into the medical record when necessary. Follows up on pending authorizations until they are obtained.

Arranged Care.

• Coordinate high volume of complicated patient care appointments, procedures, and infusion treatments as directed by physician and/or nurse staff; Uses EMR and other systems as needed for scheduling. Creates a medical record if needed. Provides personal reminders to patients about upcoming appointments. Serves as a liaison and information resource for physicians, and nursing support staff; Return patients messages (phone and/or electronic); 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. Obtains prior medical records and studies if appropriate. Arranges for wheelchairs, interpreters, or other assistive devices as necessary to support safe, high-quality care. Other duties as assigned.

Customer Service / Point of Service Operations.

• 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, exemplary phone etiquette, face-to-face customer contact skills, high emotional intelligence including during stressful situations, utilization of available information technology, consistently following standard work, flexible coverage of internal service needs and the continuous application of process improvement methods and skills. Greets patients and, where appropriate, checks them in prior to being seen by clinical staff.  Gathers and/or verifies patient information including demographics, insurance coverage, and financial status.  Checks patient account numbers and corrects any problems, seeking advice from Central Registration as required. Ensures that all appointment comment information is accurate and complete.  Enters all information accurately into OHSU databases or into the medical record when necessary.  Inspects insurance cards and/or authorization notices. Explains and satisfies any necessary patient signature requirements (including non-covered service forms). Identifies and collects co-payments, provides receipts, and completes necessary accounting procedures as needed. Notifies clinical staff when patients arrive, monitors the length of patient wait times and intervene as necessary. Distributes medication lists to patients and prepares other duties associated to clinic as needed. Validates parking as needed.

Integrated Care.

• Schedules associated clinical, diagnostic, or laboratory services; obtains authorizations when