Oregon Health & Science University · 1 day ago
PAS Resource Specialist
United States
Full-time
Remote
Entry Level
$25/hr - $34/hr
1+ years expOregon Health & Science University is responsible for managed care and patient price estimate processes within their Centralized Managed Care & Price Estimates department. The PAS Resource Specialist supports ambulatory practices and hospital departments by ensuring optimal financial services for patients and verifying insurance coverage and authorizations.
EducationHealth CareUniversities
Responsibilities
Review incoming referral orders to assess patient’s needs based on diagnosis, insurance coverage or lack thereof, and previous treatments. Referrals may be received internally via Epic or externally via fax or other methods
Verify patient information including demographics, insurance coverage and financial status. Confirm patient eligibility for health care coverage and clarify any managed care arrangements. Document any details related to liability insurance (i.e. motor vehicle accident, personal injury, or worker’s compensation) to determine third party liability
Obtains benefit information including current eligibility, deductible or co-pays, co-insurance, stoploss or out of pocket status, authorization requirements, PCP referral requirements, days approved (for routine admissions), and correct billing address
Document information based on department protocols in the Epic Referral shell
Work closely with referring providers to obtain necessary insurance referrals and authorizations
For urgent/emergent admissions, provides admit information and sets up authorizations and/or PCP referrals. Contacts care- management to provide clinical review and obtain length of stay
For routine admissions, confirms that the authorizations and/or PCP referrals cover the designated admission. If authorizations and/or PCP referrals are not noted in the system, contacts the Managed Care Coordinator from specialist’s office requesting the admission for follow up with the designated insurance company
Send notification of admission for urgent admissions
When appropriate, obtain authorizations for all clinical care, procedures, diagnostic studies, medications, outpatient infusion treatment, and inpatient admissions including notifying insurance upon admission
Follow up on all pending authorizations and/or PCP referrals until accounts are secured
Maintains current information on managed care insurance plans and serves as a liaison and information resource for patients, referring physician offices, and other OHSU staff. Applies problem solving and negotiating skills in resolving patient concerns and managed care related issues
Collects detailed information of trauma admissions (motor vehicle accident, personal injury, and/or worker’s compensation) to determine accident-related liability
Appropriately codes insurance plans in EPIC system for billing purposes
Work directly with insurance companies, the denial coordinator and the clinical staff and/or provider to supply necessary information to appeal denied claims and/or authorization requests as applicable
Appropriately code insurance plans within EPIC system for billing purposes
Provide backup support for other Managed Care coordinators within the Centralized Managed Care & Price Estimates department
For self-pay patients, complete duties associated with financial assistance determinations such as above/below the line. Including connecting patients with necessary social work or financial counseling to assist in the coverage process
Complete necessary forms prior to upcoming procedures, admissions, and/or appointments (i.e. Non-Covered Charges Form (NCCF), Advanced Beneficiary Notification (ABN) or Patient Financial Estimate (FE)) as required
Work directly with the patients and clinical team to ensure patient is knowledgeable and understands their insurance benefits and/or financial obligations
Qualification
Required
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
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
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
Excel skills and knowledge preferred
Company
Oregon Health & Science University
OHSU is a health and research university provides patient care, research, education of the next generation of health care.
10001+ employees
H1B Sponsorship
Oregon Health & Science University has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (136)
2024 (132)
2023 (121)
2022 (132)
2021 (109)
2020 (103)
Funding
Current Stage
Late StageTotal Funding
$36.6MKey Investors
U.S. Small Business AdministrationNational Institute of Allergy and Infectious DiseasesHyundai Hope On Wheels
2024-09-25Grant
2022-11-21Grant· $4.7M
2022-09-27Grant· $0.3M
Leadership Team
Tarek Salaway
Chief Executive Officer, OHSU Health
Lawrence Furnstahl
Executive Vice President & Chief Financial Officer
Recent News
2026-01-03
Genetic Engineering News
2026-01-03
2025-12-31
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