Human resource assistant serp_jobs.h1.location_city

Pas Resource Specialist

The PAS Resource Specialist is responsible for assuring that appointments and ordered services will be covered by the patient's insurance, or if uninsured, the patient is referred appropriately to obtain necessary support. The PAS Resource Specialist provides managed care services for the work unit by providing excellent customer service through prompt and professional communication skills, occasional face-to-face customer contact skills, and excellent problem solving skills. The PAS Resource Specialist also works with patients to help them to understand their insurance benefits and payment obligations. The PAS Resource Specialist works directly with providers, clinical and office staff to obtain information to carry out job duties.

Function / Duties of Position

Key Responsibilities & Performance Standards

• Verifies insurance eligibility and obtains benefits, referrals / prior authorizations and documents in patient's file. Updates insurance information on patient's accounts when applicable.
• Maintains off-site log or assists peers with maintenance by obtaining authorizations for ancillary service referrals and documentation of such.
• Reviews orders and documents treatment approvals and locations in patient's record (EMR). Monitors all treatment regimens for insurance coverage and appropriateness of indication and forwards to Manager / Formulary Committee for approval as needed.
• Functions as a "point of inquiry" and resource for all work unit staff with questions regarding insurance coverage and where scans and treatments may be done.
• Applies problem solving and negotiating skills in working with insurance companies and referring providers to obtain a successful outcome.
• Performs financial counseling with patients prior to treatment and calculates co-insurance amounts as requested or obtains costs of treatment for ABN preparation.
• Reviews additions to the schedule of same day and next day appointments from outside OHSU providers for insurance and authorizations of medications to infuse in the day treatment clinic.
• Performs research and processes paperwork for financial assistance foundations to help patients pay for specialty drugs.

Required Qualifications

Knowledge and Skills Required :

Preferred Qualifications

Additional Details

This position works in a busy office environment with multiple, competing demands; frequent interruptions, and interpersonal interactions with both internal and external customers. Hours : 8 : 30 am - 5 : 00 pm, M-F. Position requires employee to travel occasionally between the various offices of the OHSU Community Oncology work unit.

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.