Patient Access Resource Specialist

Department Overview:

The C3 Patient Access Resource Staff is responsible for providing the highest level of customer service while handling all aspects of the scheduling of clinic appointments, referral management, visit preparation, patient eligibility, and financial clearance for the Connected Care Center clinical services. This position is responsible for all aspects of scheduling and supporting patient care coordination across multiple clinical specialties. This position will respond to patient Connected Care Center scheduling requests which include but are not limited to, patient phone calls, MyChart or provider requests. The employee in this position promotes OHSU’s mission statement by delivering high quality, cost effective, patient centered, service excellence.

Function/Duties of Position:

Customer Service

• Deliver exceptional customer service to external customers (patients, families, referring providers, insurance carriers, etc.) and internal customers (OHSU healthcare providers and staff).
• Meet or exceed service standards of the healthcare industry.
• Communicate promptly and professionally.
• Demonstrate patient\-centered customer service skills.
• Handle crisis situations effectively.
• Utilize available information technology efficiently.
• Process complaints following standard procedures.
• Provide flexible coverage for internal service needs.
• Apply continuous process improvement methods and skills.

Multi\-Specialty Call Processing \& Scheduling

• Answer incoming calls and handle various inquiries related to scheduling, general information, referral status, and care\-related matters.
• Transfer calls to Nurse Triage when necessary, following established guidelines.
• Schedule and manage patient access to clinical services in the Connected Care Center.
• Record accurate and detailed information in the electronic medical record (EMR) for telephone encounters, including medication refill requests, complaints, general inquiries, and urgent healthcare concerns.
• Assess and direct calls to the appropriate staff for patient care and needs.
• Process calls promptly, professionally, and courteously.
• Provide callers with relevant information, such as directions, addresses, and operating hours.
• Utilize schedules and departmental procedures to connect callers with the appropriate on\-call personnel.
• Follow departmental policies for different types of encounters (e.g., refills, telephone consultations, documentation).
• Schedule patient appointments for Connected Care Center clinical services through various sources, including inbound calls, workqueues, clinical service requests, etc.
• Act as a liaison and information resource for physicians and nursing support staff.
• Return phone messages and send out new patient information packets via mail.
• Direct patients to the appropriate clinicians for healthcare issues.
• Process and route direct referrals to other clinical services.
• Accurately enter patient information into the Epic system.
• Utilize proper OHSU forms and documentation for all patients.
• Collaborate with providers to maintain up\-to\-date clinic templates and block schedules in Epic.
• Assist with scheduling surgical services as needed.

Registration, Managed Care, Financial Clearance

• Ensure administrative and financial preparation of patients prior to their visit by following registration workflows. Gather and verify patient information, including demographics, insurance coverage, and financial status.
• Pre\-register patients with accurate demographic data, including race, ethnicity, language, and disability information.
• Conduct financial screening using the Experian tool to determine patient eligibility for financial assistance programs.
• Transfer patients to the appropriate department to address their financial concerns.
• Confirm patient eligibility for healthcare coverage and clarify managed care arrangements.
• Enter all information accurately into Epic EMR.
• Set up reservations and admissions for elective inpatient and day patient procedures.
• Obtain managed care authorizations for consultations, procedures, office visits, and care arrangements when needed. Follow up on pending authorizations until they are obtained.
• Stay updated on managed care insurance plans and serve as a resource for physicians, nursing support staff, and colleagues.
• Provide information on authorization requirements per diagnosis and service to referring physician offices, OHSU Health Plan Office, patients, and insurance companies.
• Maintain proficiency in ICD\-10 requirements.
• Schedule appointments and coordinate with other ancillary and clinical services as necessary.
• Resolve patient concerns and managed care\-related problems using problem\-solving and negotiation skills.
• Create medical record if not already available.

Visit Preparation \& Integrated Care

• Prepare for patient visits by reviewing established visit preparation items and documenting their completion while speaking with the patient.
• Contact referring providers to obtain any necessary items that have not been obtained.
• Record, track, and verify referrals and authorizations for outpatient clinic and lab visits when required.
• Schedule patient appointments and accommodate walk\-ins as needed.
• Obtain prior medical records and studies when necessary.
• Arrange for stretchers, wheelchairs, interpreters, and other special accommodations as needed.
• Send out information packets to patients.
• Provide personal reminders to patients about upcoming appointments.
• Prepare patient for virtual visits as needed
• Prepare patient for virtual visits as needed

Referral Management:

• Process incoming referrals for the Connected Care Center clinical services.
• Verify and update patient demographics, including address, contact numbers, and primary care physician (PCP) information.
• Ensure referrals contain the minimum required information.
• Contact the referring clinic (internal or external) if any of the minimum required information is missing.
• Utilize Media Manager software in Epic to upload documents into patient charts for current medical care or referral purposes.
• Perform document scanning at the point of care, paying meticulous attention to detail to ensure accurate placement of records in the patient's chart.

Training and Competency

• Engage in relevant educational activities to enhance knowledge and skills for assigned work.
• Attend staff meetings, informational sessions, and other learning opportunities.
• Stay up to date by reading vendor documentation, trade and other relevant publications.
• Collaborate with peers and colleagues to exchange information.
• Successfully complete required initial training and core competency assessment for PAS (Patient Access Services).
• Stay up to date with all required OHSU and role specific modules.
• Maintain core competencies and consistently apply acquired skills throughout employment.
• Act as a resource for PAS expertise and share PAS information with other PAS Specialists in the service area.
• Provide instruction to co\-workers on user skills for PAS system software, including Order Entry, EPIC cadence scheduling, and the Radiology Information System (RIS).
• Possess a working knowledge of diagnostic and procedural coding, medical terminology, and maintain familiarity with service\-specific practices.
• Fill in as needed for any PAS/R position within the service area.

Other Duties as Assigned

• Including, but not limited to the following responsibilities:
• Teamwork and Collaboration: Participates with team members in daily huddle discussing daily work for the team to align with OHSU service standards. Must have strong communication, listening skills and awareness of self. Collaborate with various teams to ensure patient access to care.

Required Qualifications:

• One year of experience in a medical office setting, including high\-volume direct patient contact, scheduling of appointments and may require experience obtaining managed care authorizations (dependent on position description). OR one and a half years of work experience in a high volume direct public contact position and 6 months experience in a medical office setting. The candidate must have a thorough knowledge of PAS policies and procedures. Candidates will have demonstrated advanced PAS user skills as well as extensive knowledge of integrated care at OHSU.

Knowledge and Skills Required:

• Basic computer skills including word processing. Windows applications, on\-line scheduling, and a preference for data\-base skills. Excellent verbal and written communications skills. Strong customer service orientation. Demonstrated effectiveness in confrontational customer interactions.

Preferred Qualifications:

• Advanced Degree
• Basic computer keyboarding skills including typing of 40\-50 wpm.
• Proficient computer skills including word processing.
• Extremly high level of attention to detail. Strong customer service orientation.
• Must have excellent verbal and written communication, listening skills and awareness of self.
• Demonstrated reliable attendance record.
• 2\+ years patient scheduling experience.
• 2\+ years experience working in healthcare, preferably Urology, Neurology, Neurosurgery, GI, or Imaging
• Experience working with an electronic health record.

Additional Details:

• Monday\-Friday during normal hours of operation.
• This position works in a busy environment with many interruptions, multiple demands and interactions.
• This position will handle a high volume of patient phone calls, high level of multi tasking, and scheduling.
• This position requires sitting for at least 2 hours at a time. Heavy use of computers and multi\-line phones. Ability to lift and carry 25 pounds. Ability to speak clearly, demonstrate patience and understanding of customer needs. Must be able to deal with competeing needs and priorities of internal customers. Must be able to work independently from a remote location