Patient Representative (Patient Account Rep 1) at Oregon Health & Science University

Department OverviewAs the Patient Representative you will review accounts refund patients and insurance companies. Assist Tuality cash team as needed by sorting/dist. mail scanning refund and other documents as needed into Onbase.In this role your duties will include bill process adjustments collect on accounts and/or perform customer service duties to ensure that monies due University Hospital are secured and paid in a timely manner and the AR outstanding days of revenue arekept to a minimum. Assignment will be flexible depending on payor mix patient flow and workloadfluctuationsFunction/Duties of PositionThird party follow-up and collection:Within the stratified processing environment collect assertively and proactively money due OHSU by contacting (through telephoningemailing and/or accessing on-line systems) third parties (insurance carriervarious government programs etc.)Provide explanation of charges and additional requested information to the third parties.Analyze accounts to determine coordination of benefits refunds and denials to insure appropriate resolution of accounts.Review billing to determine medical records necessary to provide complete processing of claim. Analyze accounts with regard to billing and payment history and uses judgment to determines appropriate follow-up action based on departmental guidelines Contact patient/guarantor to resolve issues (includes tracing and locating patient/guarantor by telephoning and/or sending written correspondence.) Analyze accounts and interpreting contracts that dictate how claims should be paid and processing adjustments for contract interpretation. Comply with special billing and follow-up requirements regarding adoptions court holds motor vehicle and personal injury accidents and other unique or sensitive accounts Work reports of denied claims to trend and report these claims to the department and to our front end partners Work closely with admitting care management and ambulatory services on the denied claims for resolution and feedback purposes Prepare the appeals for selected denialsBillingSubmit bills that comply with all appropriate regulations managed care contracts to third party payors.Calculate the correct reimbursement of all managed care claimOther Duties as AssignedRequired QualificationsTwo years of recent (within the last 5 years) experience billing or collecting healthcare accounts in a business office; ORFour years of general collection billing or customer service experience; OREquivalent combination of education and experience.Certified Revenue Cycle Specialist (CRCS) is required within 18 months of hire. Positions outside of Patient Business Services may not require certification.Must be able to perform the essential functions of the position with or without accommodationPreferred Qualifications1 year of recent medical collection and/or billing experience. Work experience must have occurred within five years of the date of hire. Recent (within one year of date of hire) Microsoft Office Suite experience in Windows environment with skill in document production using WORD spreadsheet construction in EXCEL. Familiarity with DRG CPT HCPC and ICD-10 coding.Job Related KnowledgeSkills and Abilities(Competencies):Typing 45 wpm Ability to use multiple system applications Demonstrated ability to communicate effectively verbally or in writing. Demonstrated ability to prioritize and accomplish multiple tasks in a fast paced environment; consistently adhering to defined due datesExperience in billing Hospital claims or UB-04 claims. Knowledge of and experience in interpreting managed care contracts.Must be able to perform the essential functions of the position with or without accommodationAdditional DetailsBenefits:Healthcare Options - Covered 100% for full-time employees and 88% for dependents and $25K of term life insurance provided at no cost to the employeeTwo separate above market pension plans to choose fromVacation- up to 200 hours per year depending on length of serviceSick Leave- up to 96 hours per year8 paid holidays per yearSubstantial Tri-met and C-Tran discountsAdditional Programs including: Tuition Reimbursement and Employee Assistance Program (EAP)All are welcomeOregon 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 or Required Experience:Unclear Seniority Key Skills Air Ticketing,API,CAD CAM,Data Management,Equity,Import & Export Employment Type : Full-Time Experience: years Vacancy: 1