PAS Revenue Cycle Specialist - Relief

Department Overview

To support Oregon Health Sciences University’s mission by providing exemplary service to all patients, patient families, visitors, and staff who present to any area of Patient Access Services Department in person, via telephone, or over electronic communication. To greet, interview, register, and pre-register patients scheduled for hospital admission.  Creates reservations for day patient and Inpatient admissions and complete Inter-Hospital transfers.  Obtains and records demographic and insurance data to ensure accurate patient identification to facilitate payment and compliance with all regulatory requirements.  Performs employee requirements as outlined in Compliance Roles and Responsibilities, Code of Conduct and Respect at the University for OHSU Hospital and Clinics.  

Function/Duties of Position

CUSTOMER SERVICE:

• Provides high quality customer service to both external and internal customers that meets or exceeds the service standards of the health care industry.
• Promptly greet all patients, visitors, and others in a warm, courteous, and professional manner, face to face or over the phone.
• Demonstrates the ability to communicate effectively, timely, and respectfully at all times, especially in a high stress environment.
• Provides flexible coverage to assist with internal service needs and the continuous application of process improvement methods and skills.
• Determines customer needs proactively, and direct inquiries to appropriate resources.
• As problems and miscommunications occur with internal or external customers, demonstrates the ability to clarify and resolve problems immediately to avoid further communication breakdowns.
• Demonstrates respect and cooperation in all staff relationships, with a genuine willingness to prevent or resolve inter-personal conflicts.
• Demonstrates knowledge of all department locations, units, and buildings on OHSU Campus.
• Answers multi-line telephone inquiries.  Determine caller needs and assist callers efficiently and appropriately.
• Determine priorities and act quickly, make decisions efficiently and in a calm manner in emergency and stressful situations.

PATIENT REGISTRATION/INTERVIEWS:

• Gathers, adds, updates, and/or verifies detailed demographic information and completed/signed forms required for services. These functions are performed at stationary computer terminals or at patient’s bedside using a mobile computer terminal, occasionally over the phone.  Hand written documentation may only be utilized during computer downtime or device malfunction.
• Completes Race, Ethnicity, Language, and Disability (REALD) questionnaire with patient face to face or over the phone and updates REALD Smart Form as required by law. Serves as liaison for patients and families with questions.
• Satisfies state regulations to identify support persons for individuals with disabilities.
• Correctly identifies patient service type to establish an accurate and billable account.
• Corrects patient identity inaccuracies, as identified.
• Schedules reservations into Epic with a base knowledge of diagnoses and procedures.
• Validates appropriate admitting locations by procedure and admitting provider to ensure appropriate patient placement.
• Accurately complete Inter-Hospital Transfers and same-day admissions and obtain prior medical records as needed.
• Activates direct admissions based on notification from unit at time of patient’s arrival.
• Follows Oregon Administrative Rules (OAR’s) regarding workers’ compensation in operation of OHSU and industry workman’s compensation procedures. Provides timely follow up for completion of workman’s compensation “827” and DOLI form for work related injuries.

INSURANCE VERIFICATION/FINANCIAL CLEARANCE:

• Gathers, adds, updates, and/or verifies detailed insurance coverage and financial status with each patient over the phone or face to face.
• Creates new and maintains existing insurance coverages/guarantors for a patient based on their insurances and the care being provided.
• Obtains benefit information including deductible or co-pays, co-insurance, stoploss or out of pocket status, and correct billing address.
• Complete insurance verification on each patient’s insurance 100% of the time when the insurance verification status says New, Elapsed, Incomplete, Needs Review, or is Medicaid, using electronic verification in RTE, payer portals, or other required methods. The PAS Revenue Cycle Specialist staff will also re-verify the eligibility insurance information if the insurance was not verified in the current month. 
• Reviews MMIS for all uninsured or single coverage patients
• Refe