- Communicate professionally with OHSU staff and third-party customers including departments and insurance companies to ensure timely and accurate processing of account transactions.
- Uses independent decision making in the moment acting as patient advocates in helping customers/patients satisfactorily resolve issues with our “one touch” philosophy. Each interaction will be handled promptly, efficiently, and courteously.
- Uses independent judgment to decide when to process Insurance adjustments.
- Identifies trends in problematic billing processes and escalates issues and proposed solutions to management for resolution.
- Review Aged A/R along with WQ volume to independently prioritize work.
- Completes complex and variable billing claims for medical insurers, auto insurers, SAIF/Workers' Compensation insurers, managed-care contracts, special grants, government agencies and Student health clinics.
- Ensures that all billing information is complete and accurate; ensures that billing claims are coded correctly and transferred to the appropriate parties when coding errors are discovered.
- 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.
Four years of recent (within the last 5 years) experience billing or collecting healthcare accounts in a business office; OR
Six years of general collection, billing or customer service experience; OR
Equivalent combination of education and experience.
Certified Revenue Cycle Specialist (CRCS) is required within six 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.
- High school diploma or equivalent OR Related experience as defined below.
- Knowledge in ECA reporting tools.
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