CCMC Transplant Coordinator; Patient Account Coordinator

Responsible for the complete billing, adjustment processing, follow-up, and collection of complex Transplant accounts to ensure timely and accurate reimbursement to University Hospital. This specialized role requires independent management of the entire revenue cycle for high-dollar, high-risk transplant cases, including detailed analysis of accounts, identification of payment barriers, development of resolution strategies, and coordination with multiple internal and external stakeholders.

Billing

• Manage the specialized billing, claim editing, and follow-up for Transplant claims to ensure accurate, timely, and compliant submission to CCMC payers.
• Coordinate closely with Professional Billing (PB) to prepare and submit combined invoices and claims during the global billing period.

Third party follow-up and collection

• Within the stratified processing environment, collect assertively and proactively money due OHSU by contacting (through telephoning, emailing, and/or accessing on-line systems) third parties (insurance carrier, various government programs, etc.)
• Provide explanation of charges and additional requested information to the third parties.
• Analyze accounts to determine coordination of benefits, refunds, and denials to insure appropriate resolution of accounts.
• Review billing to determine medical records necessary to provide complete processing of claim.
• Analyze accounts with regard to billing and payment history and uses judgment to determines appropriate follow-up action based on departmental guidelines.
• Contact patient/guarantor to resolve issues (includes tracing and locating patient/guarantor by telephoning and/or sending written correspondence.)
• Analyze accounts and interpreting contracts that dictate how claims should be paid and processing adjustments for contract interpretation.
• Comply with special billing and follow-up requirements regarding adoptions, court holds, motor vehicle and personal injury accidents, and other unique or sensitive accounts.
• Prepare the appeals for selected denials.

AR Oversight

• Monitor AR aging and performance through regular reporting and data analysis.
• Identify systemic issues and proactively elevate with payers to resolve barriers to payment.
• Communicate progress, challenges, and trends to Revenue Cycle leadership, Contracting, and clinical departments to support timely resolution and continuous improvement.

Other duties as assigned.

• 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.
• Certified Revenue Cycle Specialist (CRCS) is required within 18 months ofhire.

• Knowledge of and experience in interpreting managed care contracts.
• Familiarity with DRG, CPT, HCPC and ICD-9 coding.
• Recent (within one year of date of hire) Microsoft Office Suite experience in Windows environment with skill in document production using WORD, spreadsheet construction in EXCEL.
• EPIC certification in HB Resolute preferred.
• Typing at or above 45 wpm.
• Ability to use multiple system applications.
• Demonstrated ability to communicate effectively verbally or in writing.

Monday through Friday.
1 day per week in office, otherwise remote position.

Deal with hostile, grieving, or angry people on a daily basis.

Benefits

• 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…