Managed Care Coordinator – PAS Resource Specialist

Oregon Health & Science University Foundation

. Review incoming referral orders to assess patient needs based on diagnosis, insurance coverage or lack thereof, and previous treatments .

Posted 9/21/2026full-timePortland • Oregon • United StatesJunior💰 $28 - $38 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managed care processes, including insurance verification, authorization, and referral management using EPIC. Possesses strong problem-solving, negotiation, and communication skills to effectively resolve patient concerns and ensure compliance with managed care policies.

Highest-signal resume keywords

Managed Care AuthorizationInsurance VerificationEPIC ProficiencyPatient Financial CounselingHigh-Volume Scheduling

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical TerminologyManaged Care PoliciesAuthorization ProcessesInsurance CodingElectronic Medical Record SystemsFinancial Assistance DeterminationPatient Liability EstimatesMulti-Line Phone SystemScheduling SoftwareData Entry

Soft Skills

Problem SolvingNegotiation SkillsAttention to DetailCustomer Service OrientationEffective Communication

Tools & Technologies

OHSU EpicMS WordMS ExcelMS AccessManaged Care Websites

Certifications & Qualifications

High School DiplomaGED

Industry Keywords

Managed CarePatient AdmissionsThird-Party LiabilityFinancial CounselingReferral Management

About the role

Key responsibilities & impact

Review incoming referral orders to assess patient needs based on diagnosis, insurance coverage or lack thereof, and previous treatments
Verify patient demographics, insurance coverage, financial status and eligibility
Clarify managed care arrangements and document third-party liability information
Obtain benefit information including deductibles, copays, coinsurance, out-of-pocket status, authorization and PCP referral requirements, approved days, and billing address
Document information in the Epic Referral shell according to department protocols
Work with referring providers to obtain insurance referrals and authorizations
Provide admit information and arrange authorizations or PCP referrals for urgent/emergent admissions
Confirm authorizations and PCP referrals for routine admissions
Notify insurance companies upon admission when appropriate
Obtain authorizations for clinical care, procedures, diagnostic studies, medications, outpatient infusion treatment and inpatient admissions
Follow up on pending authorizations and PCP referrals until accounts are secured
Maintain current managed care insurance plan information and serve as a liaison for patients, physician offices and OHSU staff
Resolve patient concerns and managed care issues using problem-solving and negotiation skills
Collect trauma admission information to determine accident-related liability
Code insurance plans appropriately in Epic for billing purposes
Support denied-claim and authorization-request appeals by providing necessary information
Provide backup support for other Managed Care Coordinators
Complete financial assistance determination duties for self-pay patients and connect them with social work or financial counseling
Complete required forms such as NCCF, ABN and Patient Financial Estimate forms
Review work queues for patients needing estimates
Create Patient Liability Estimates
Complete pre-registration by phone as applicable
Contact patients before service to explain estimates and collect pre-payments
Perform other duties as assigned

Requirements

What you’ll need

One year of experience in a medical office setting in a managed care position, including high-volume scheduling of appointments, multi-line phone system, medical terminology, verifying medical insurance and obtaining managed care authorizations; OR 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
Thorough knowledge of PAS policies and procedures
Demonstrated advanced PAS user skills and extensive knowledge of integrated care at OHSU
Thorough knowledge of managed care policies and procedures, as well as authorization and referral processes in EPIC
Thorough knowledge of verifying medical insurance including worker’s comp and third-party liability
Experience with electronic scheduling, managed care websites and electronic medical record systems
Basic computer skills, including MS Word, Excel and Access, OHSU Epic skills and online resource use knowledge
Excellent written and verbal communication skills
Knowledge of managed care and insurance verification policies and procedures, including appropriate timelines, paperwork, regulations, communication and follow-up
Efficiency, problem solving and negotiation skills in resolving patient concerns and managed care/insurance related problems
Ability to meet department performance standards for efficiency, production, timeliness and accuracy
Ability to multi-task in a high-volume situation
Strong attention to detail and processes
Ability to work autonomously with a high level of accuracy and speed and willingness to work with deadlines
Strong customer service orientation
Demonstrated effectiveness in confrontational customer interactions
Preferred: High School Diploma or GED
Excel skills and knowledge preferred
Must be able to share office space with other coworkers and multi-task in a high-volume environment

Benefits

Comp & perks

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
Opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington
AFSCME union representation