PAS Revenue Cycle Specialist

Department Overview

The Centralized Check-In department is responsible for signing-in/admitting patients for their procedures and/or appointments at the Center for Health and Healing and Beaverton campuses, as well as any new locations identified across OHSU Health in the future. If the patient has multiple procedures/appointments for that day, on a given campus, the Centralized Check-In process will allow the department to check-in/admit the patient for all care at one time. The Centralized Check-In department is also responsible for kicking off patients, event tracking, and signaling so that all care teams within the campus know where the patient is at in their care. Prior to signing-in/admitting a patient, the Centralized Check-In department is responsible for helping to resolve any critical properly-prepared patient items that have not been completed (i.e. patient demographic and insurance/registration verification). Lastly, the Centralized Check-In department is responsible for greeting patients on specified floors within the campus to ensure patients are in the right place for their initial/next episode of care.

Function/Duties of Position

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, occasionally over the phone or at beside with paper forms and/or a tablet. 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.
• Provides patient education regarding OHSU financial assistance, insurance coordination of benefits, Patient Rights, Terms & Conditions, Advance Directives, Medicare Secondary Payer Questionnaire, Medicare and Commercial notices of Non-Covered services (ABN or NCCF), Important Message from Medicare, Release of Information, Special Consent, Champus Message to patients and their representatives, Notice of Privacy Practices, use of patient information and/or specimens in OHSU research, and other facility or regulatory documents.
• Obtains signatures and enters into computer all facility and regulatory required data and forms. Reviews all for accuracy.
• Responsible for all identity management corrections after hours.
• Identifies and collects co-pays, deductible payments, deposits, and prepayments for services as required.
• Creates and assembles surgical patient intake form packets for the surgical floors
• Determines urgent/emergent medical situations and activates rapid response team or engages the assistance of nursing staff to assist.
• Follow and complete daily task list as assigned by management.

Enrollment & Authorization:

• Gathers, adds, updates, and/or verifies patient information including detailed demographics, detailed insurance coverage/benefits, MyChart enrollment, 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.
• 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
• Refers all non-sponsored patients to Oregon Health Plan (OHP) and provides information for financial assistance, working closely with Financial and Medicaid Services.
• Ensures all required forms are completed for services and confirmation of pay