Department Overview

OHSU is Oregon's only public academic health center. We are a system of hospitals and clinics across Oregon and southwest Washington. We are an institution of higher learning, with schools of medicine, nursing, pharmacy, dentistry and public health - and with a network of campuses and partners throughout Oregon. We are a national research hub, with thousands of scientists developing lifesaving therapies and deeper understanding. We are a statewide economic engine and Portland's largest employer. And as a public organization, we provide services for the most vulnerable Oregonians, and outreach to improve health in communities across the state.

The Patient Accounts Representative 1 processes billing for hospital and clinic patient charges and is responsible for the collection and resolution of accounts to ensure that monies due University Hospital are secured and paid in a timely manner and the AR outstanding days of revenue are kept to a minimum. Assignment will be flexible depending on payor mix, patient flow, and workload fluctuations. This level is distinguished from the lower level by a higher level of decision making and analysis, as well as broader scope of responsibility.

Function/Duties of Position

Customer Service:

* Receive incoming phone calls relating to issues with patient account, completing 66 incoming calls each day.

* Process patient request to combine accounts and set up payment arrangements

* Review for inappropriate charges

* Determine which accounts should be escalated to supervisor attention

* Take necessary steps to resolve customer concerns

* Respond to 10 pieces of written correspondence each day.

Billing:

* Submit bills that comply with all appropriate regulations, managed care contracts to third party payors

* Calculate the correct reimbursement of all managed care claims

Third-party follow-up and collection:

* Within the stratified processing environment, collect assertively and proactively money due OHSU by contacting (through telephoning, emailing, and/or accessing on-line systems) third parties (insurance carrier, various 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.

Patient Counseling and Collections:

* Analyze delinquent accounts with regard to billing and payment history. Determines appropriate follow-up action based on departmental guidelines; trace and locate debtor by telephoning and/or sending written correspondence.

* Arrange appropriate payment plan within prescribed guidelines; request and review documentation of financial information regarding ability to pay and eligibility for financial allowances.

* File claims to estates of deceased patients.

* Determines which accounts should be referred to external collection agencies; prepare accounts for transmittal to collection agencies and/or other State agencies when internal collection efforts are determined to be inadequate

* Provide information to outside agencies involved in collection action or legal action against debtor.

Adjustment and legal document preparation:

* Analyze accounts and process adjustments for charge errors, contract, and financial allowances

* Prepare legal documents such as estate filing

Required Qualifications

* Two years of recent (within the last 5 years) experience billing or collecting healthcare accounts in a business office; OR

* Four years of general collection, billing or customer service experience; OR

* Equivalent 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.

Preferred Qualifications

Experience:

* 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

* Experience in billing Hospital claims or UB-04 claims.

* Knowledge of and experience in interpreting managed care contracts.

* Familiarity with DRG, CPT, HCPC and ICD-10 coding.

* Must be able to perform the essential functions of the position with or without accommodation.

Job Related Knowledge, Skills and Abilities (Competencies):

* Typing 45 wpm Ability to use multiple system applications.

* Demonstrate ability to communicate effectively verbally or in writing.

* Demonstrate ability to process detail oriented and analytical work.

* Demonstrate ability to prioritize and accomplish multiple tasks in a fast paced environment; consistently adhering to defined due date.

Additional Details

Schedule: 8:15am - 4:45pm with 1/2 lunch or 7:45am to 4:45pm for 1-hour lunch. No flex time.

Benefits:

* Two raises per year - One at anniversary date and one across the board annual increase

* Healthcare Options - Covered 100% for full-time employees and 88% for dependents, and $25K of term life insurance provided at no cost to the employee

* Two separate above market pension plans to choose from

* Vacation- up to 200 hours per year depending on length of service

* Sick Leave- up to 96 hours per year

* 8 paid holidays per year

* Substantial Tri-met and C-Tran discounts

* Additional Programs including: Tuition Reimbursement and Employee Assistance Program (EAP)

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.