Customer Service Rep (Patient Account Rep 1)

US-OR-Portland

Requisition ID: 2026-42805
Position Category: Hospital/Clinic Support
Job Type: AFSCME union represented
Position Type: Regular Full-Time
Posting Department: Patient Business Services
Posting Salary Range: $26.16 - $35.38 per hour, with offer based on relevant qualifications and internal equity
Posting FTE: 1.00
Posting Schedule: Monday - Friday
HR Mission: Central Services
Drug Testable: No

Department Overview

To bill, process adjustments, collect on accounts, and/or perform customer service duties to ensure that monies due University Hospital are secured and paid in a timely manner and the AR outstanding days of revenue are kept to a minimum. Assignment will be flexible depending on payor mix, patient flow, and workload fluctuations.

Function/Duties of Position

Billing

• Submit bills that comply with all appropriate regulations, managed care contracts to third party payors.
• Calculate the correct reimbursement of all managed care claims.

Third party follow-up and collection

• Within the stratified processing environment, collect assertively and proactively money due to 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 to determine coordination of benefits, refunds, and denials to insure appropriate resolution of accounts.
• 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.
• Work reports of denied claims to trend and report these claims to the department and to our front end partners.
• Work closely with admitting, care management and ambulatory services on the denied claims for resolution and feedback purposes.
• Prepare the appeals for selected denials.

Other duties as assigned.

Required Qualifications

• Two years of recent (within the last 5 years) experience billing or collecting healthcare accounts in a business office; OR

• Four years of general collection, billing or customer service experience; OR

• Equivalent combination of education and experience. 

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

Preferred Qualifications

• 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.
• Experience in billing Hospital claims or UB-04 claims.
• Knowledge of and experience in interpreting managed care contracts.
• Familiarity with DRG, CPT, HCPC and ICD-10 coding.
• Typing 45 wpm.
• Ability to use multiple system applications.
• Demonstrated ability to communicate effectively verbally or in writing.

Additional Details

Monday through Friday. This is a hybrid position in office and remote.

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 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.

PI288230690