Medicare Coordinator (Patient Account Coordinator 1)

• Monitor billing and follow-up work queues and worklists. Develop an action plan to ensure that all billable claims and follow-up WIP goals are met by the end of each week.
• Act with delegated authority as a liaison between manager and staff. Expedite assistance for staff with questions or issues and promote revenue collection.
• Analyze workflow and implement process improvement solutions when necessary.
• Provide leadership within the Medicare team and actively participate in other roles within the department.
• Develop detailed knowledge of government programs, regulations, and reimbursement methodologies.
• Represent Manager and PBS to outside payers, agencies and OHSU departments.
• Review all accounts on Medicare high dollar reports to determine if assistance is needed to ensure prompt resolution; coordinate with lead workers as necessary to expedite payment.
• Monitor monthly aging reports to ensure timely primary and secondary billing and coordinate referral processes between teams.
• Perform team account reviews to ensure quality follow-up and collection of accounts.
• Work with team to update and maintain procedures and compile training manuals.
• Monitor CMS and Medicare websites weekly for updates and disseminate program information to Team members and other OHSU departments as appropriate.
• Perform random remittance advice reviews to identify patterns; research and implement corrections/changes as needed, ensure regulatory compliance, and work with third parties as needed to maximize revenue collection.
• Perform periodic internal audits of posted transactions to ensure Cost Report accuracy and maximum cash collection.
• Ensure guidelines are implemented, enforced and updated as appropriate.
• Assist with implementation of regulatory changes. Work with PBS staff, other OHSU departments and third parties as necessary.
• Assist with coordinating responses to Medicare/OIG/RAC audits. Maintain files for retention.
• Support Manager as needed in working with OHSU’s Office of Integrity and/or legal department.
• Perform internet research of CMS/Medicare regulations to provide OHSU departments with requested information.
• Perform bi-weekly timekeeping reviews to correct errors before each payroll run. Prepare and maintain team vacation calendar.
• Keep attendance spreadsheets accurate and current in accordance with the PBS Attendance Policy. Maintain confidentiality.
• Attend TRAC meetings. Update team following meetings.
• Review the Weekly Report Set by end of day Monday to ensure accuracy and completeness.
• Attend meetings as requested, schedule team meetings, and prepare agendas for meetings.
• Review and authorize vacation schedules and reallocate work as appropriate.

• CRCS certification required. Positions outside of Hospital Patient Business Services may not require certification.
• EPIC certification in HB Resolute preferred.
• 3 years of recent medical collection and/or billing experience. Work experience must have occurred within 5 years of hire date.
• Experience in hospital billing and/or UB-04 claims.
• Knowledge of and experience in interpreting managed care contracts.

• Four years of general office or secretarial experience; OR
• An Associate’s degree or certificate in office occupations or office technology and two years of general office or secretarial experience; OR
• A Bachelor’s degree and two years of general office or secretarial experience; OR
• An equivalent combination of training and experience.

• Familiarity with Epic applications
• Experience working with a variety of reimbursement methodologies
• Knowledge and experience with APC’s
• Ability to use online coding applications
• Experience with the Medicare program within last 3 years.
• Demonstrated leadership abilities in a team environment
• Extreme confidentiality required
• Ability to work and perform in a high volume environment
• Proficient in Microsoft Office Suite applications in Windows environment
• Internet research experience
• Familiarity with DRG, CPT, HCPCS and ICD-10 coding, familiar with modifiers and their use
• Ability to interpret regulations, policies, laws, rules, contracts, etc.
• Detail oriented, analytical with strong written and oral communication skills
• Flexibility required due to frequently changing regulations
• Ability to work independently with minimal supervision
• Proficient in Microsoft Office Suite applications in Windows environment
• Ability to use multiple system applications
• Detail oriented, analytical with strong written and oral communication skills

• 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)

Oregon Health & Science University