C3 Patient Access Resource Specialist

About this role

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

• Communicate promptly and professionally.

• Demonstrate patient-centered customer service

• Handle crisis situations

• Utilize available information technology

• Process complaints following standard

• Provide flexible coverage for internal service

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

• 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

• Assess and direct calls to the appropriate staff for patient care and

• Process calls promptly, professionally, and

• 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

• Process and route direct referrals to other clinical

• Accurately enter patient information into the Epic

• Utilize proper OHSU forms and documentation for all

• 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

• 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

• Set up reservations and admissions for elective inpatient and day patient

• 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

• 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

• Obtain prior medical records and studies when

• Arrange for stretchers, wheelchairs, interpreters, and other special accommodations as needed.

• Send out information packets to

• Provide personal reminders to patients about upcoming

• Prepare patient for virtual visits as needed

Referral Management:

• Process incoming referrals for the Connected Care Center clinical

• Verify and update patient demographics, including address, contact numbers, and primary care physician (PCP) information.

• Ensure referrals contain the minimum required

• 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…