This role focuses on resolving insurance denials and processing transactions for Oral Surgery and Urology accounts to maximize aged AR resolution. Responsibilities include communicating with third-party payers, performing quality assurance reviews, and implementing LEAN processes.
Department Overview
This position primarily resolves insurance denials, documents transactions on insurance accounts, interacts with insurance companies and agencies in resolution of unpaid balances, refunds, and other Professional billing issues.
Function/Duties of Position
- Process transactions on insurance accounts; ensure account is set up correctly, problem resolution, appeals and audit transaction activity.
- Communicate professionally with OHSU staff and third-party customers including departments and insurance companies to ensure timely and accurate processing of account transactions.
- Review a variety of general and specialty Oral Surgery & Urology claims including third party claims (i.e. MVA settlements, workers compensation claims.
- Performing and documenting quality assurance reviews on transactions in department.
- Prioritize assigned accounts to maximize aged AR resolution.
- Trending provider activity and the denials that may arise.
- Researching and forwarding documentation for Revenue Cycle Business Analyst to present to department, including updating files with current regulations, policies, and procedures.
- Promote and implement LEAN processes.
- Other duties as assigned.
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.
Must be able to work with a diverse team and customer base.
Accurate data entry skills, ability to work with deadlines while remaining calm, flexible, and organized.
Excellent communication, both written and verbal and listening skills.
Able to use reason and logic to independently solve problems and to multi-task as needed.
Proficiency with standard office equipment and software such as such as Microsoft Office, knowledge of Healthcare Information Systems.
Preferred Qualifications
- High school diploma or equivalent.
Additional Details
Ability to work from home. Flexible schedule Monday - Friday during regular business hours 5am to 7:30pm. Employee can choose between five eight-hour shifts, or four nine-hour shifts and one four-hour shift, or four ten-hour shifts.
Benefits
- Healthcare for full-time employees covered 100% and 88% for dependents.
- $50K 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 dependent on length of service.
- Sick Leave - up to 96 hours per year.
- 9 paid holidays per year.
- Substantial Tri-Met and C-Tran discounts.
- Employee Assistance Program.
- Childcare service discounts.
- Tuition reimbursement.
- Employee discounts to local and national businesses.
Why apply to OHSU?
We are Oregon's only public academic health center. In addition to caring for patients, we lead groundbreaking research. We also train the next generation of health care professionals. As Portland's largest employer, we give you opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington.
All are welcome. OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti-racist, multicultural institution and encourage people with diverse backgrounds to apply. To request reasonable accommodation, contact askhr@ohsu.edu