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Job Offer: Program Representative 1:Oregon State University

Job description:

Program Representative 1

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Please see Special Instructions for more details.

To ensure full consideration, applications must be received by July 17th, 2022. Applications will continue to be accepted after the full consideration date, until a sufficient applicant pool has been achieved or the position is filled. The closing date is subject to change without notice to candidates.

Applications will be reviewed located on the information submitted on the employment profile with education and work history along with any other requested documentation i.e. posting specific question responses, transcripts, etc. Your profile MUST clearly show how you meet the minimum/required qualifications for the position. Resumes are NOT accepted at the application stage for classified staff positions.

Typically, the starting income is at the lower end of the income range.

For additional information Contact Us by: Robin Prososki at robin.prososki@oregonstate.edu

OSU is committed to the health of our local and global community. All employees and students are required to comply with the university's COVID-19 Vaccination Program. Please visit https://covid.oregonstate.edu/ for additional information about OSU's plans for safety and success, as well as options for compliance with the vaccination program.

OSU commits to inclusive excellence by advancing equity and diversity in all that we do. We are an Affirmative Action/Equal Opportunity employer, and particularly encourage applications from members of historically underrepresented racial/ethnic groups, women, individuals with disabilities, veterans, LGBTQ community members, and others who demonstrate the capability to help us achieve our vision of a diverse and inclusive community.

This position is designated as a critical or security-sensitive position; therefore, the incumbent must prosperously complete a Criminal History Check and be determined to be position qualified as per OSU Standard 576-055-0000 et seq. Incumbents are required to self-report convictions and those in Youth Programs may have additional Criminal History Checks every 24 months. Offers of employment are contingent upon meeting all minimum qualifications including the Criminal History Check Requirement.

Position Details

Position Information

Department Student Health Services (MSH)
Classification Title Program Representative 1
Job Title Program Representative 1
Appointment Type Classified Staff
Job Location Corvallis
Position Appointment Percent 100
Appointment Basis 12
Pay Method Hourly
Pay Period 16th - 15th of the following month
Pay Date Last working day of the month
Min income $20.62
Max income $31.40
Employment Category Regular
Position Summary This recruitment will be used to fill one full-time Program Representative 1 position for Student Health Services (SHS) at Oregon State University (OSU).

Student Health Services provides health care services and health education to the students of Oregon State University. Under the direction of the Support Services Manager this position supports the everyday administrative operations of SHS and works with confidential and time-sensitive information involving student health information. This is a completely remote position where the person in this function will work independently from a remote location with support supplied by SHS.

The Program Representative 1 is responsible for the billing of health center charges, in a human medical setting, through the electronic health record software to insurance companies and to student accounts. The position is charged with ensuring claims are coded correctly and troubleshooting claims errors to confirm the accuracy of the billing records which comply with the claims, coding and coverage requirements of each insurance company or agency. The position is also responsible for submitting claims and for collecting, posting and managing a wide variety of account payments and reconciliation. These tasks require a high degree of follow up with insurance companies, mail handling, public contact/information dissemination, and billing of charges to campus departments and student accounts.

The Program Representative 1 is tasked with billing out SHS charges to insurance programs offered to eligible OSU students, to the CCARE program, third party billing, Motor Vehicle, Worker's Compensation, Athletic claims, as well as to private insurance at the request of the students. These local, state, and federal programs require a high level of expertise and skills to ensure complete and accurate billing and meet the billing requirements imposed by the programs.

The Program Representative 1 ensures that chargeable procedures and services are recorded accurately and in a timely fashion, to satisfactorily complete the billing of services rendered. The Program Representative 1 also receives payments and prepares everyday cash deposits. The Program Representative 1 is responsible for responding to questions regarding insurance company programs and requirements by phone, in person and emails. This position provides skills in, and acts as an educator for multiple insurance billing requirements to the clinicians and providers regarding the unique programs the students may be utilizing. This work is done on the phone, in virtual meetings or by email. The Program Representative 1 responds to numerous questions from clinicians and providers regarding federal coding requirements utilizing ICD-10, CPT codes and HCPCS.

The employee in this position will engage regularly with staff members in the Administrative Services office, SHS staff and clinicians, clients, patients, and students on behalf of Student Health Services. The employee in this position will assist with the determination of appropriate and correct billing, problem resolution and corrective action(s) required to prosperously complete the reimbursement of covered services and comply with the billing requirements of the agencies and insurance programs and upload final charges to student accounts. The position requires a high degree of capability to interpret current guidelines, regulations and rules in order to ensure proper compliance with State/Federal and correct coding requirements.

This position responds to questions and provides information and assistance to patients, Student Health services staff, and the university community, which requires the exercise of responsible judgment, tact, efficiency, and the capability to work under pressure. The individual in this position must be able to prioritize their time according to the work and multiple deadlines. They must be able to re-direct themselves as situations change and act proactively in solving or referring patient problems and complaints.

Position tasks 50% COMPLIANCE, INTERPRETATION OF POLICY, CODING
Compliance, Interpretation of Policy, and Coding requirements of local, statewide, and federal guidelines
Review encounters received for all pertinent information: patient information, insurance, information, ICD-10, CPT, HCPCs.
Analyze and ensures accuracy of information within the billing system and monitoring of claims submission, review, and correct claims for adjudication.
Review and correct CPT, HCPCs and diagnostic coding of patient services within the health center.
Serves as a point of contact for all correspondence and inquiries pertaining to billing issues within SHS.
Assigns tasks as needed for timely filing of claims and everyday reconciliation.
Prints reports regarding claims.
Explains private insurances to students.

30% ACCOUNTS RECEIVABLE AND BILLING

Reconcile charges within billing systems and electronic clearinghouses.
Prepare and submits clean claims to various insurance companies either electronically or by paper.
Perform various collection actions including, but not limited to insurance and student payments, correction, and resubmitting of claims to third party payers.
Routine follow up of claims submitted to OSU sponsored insurance plans as well as CCARE, and Athletic third-party billing to see if claims are accepted and/or denied.
Process payments from insurance companies and prepare a everyday deposit or assigns task as needed.
Receive and record student cash and check payments. Provide documentation and supporting documents for needed Journal Vouchers.
Perform the billing for Worker's Compensation (SAIF), Oregon Health Plan, Athletic Department, Motor Vehicle Accidents, and other claims.
Prepare claims submissions for Domestic, International Student Insurance plans, and Graduate plan.
Record information in EMR and Excel spreadsheets regarding billing information.
Process charges for Occupational Health.

10% ADMINISTRATIVE SERVICES
Serve students who request bills and make payments, exhibiting at all times a strong customer service orientation.
Assist the Insurance Liaison in answering insurance questions.
Assist in the resolution of student complaints related to the billing.
Assist in Oregon CCare Office qualifying candidates and program enrollment when the CCare office staff is absent. Also assist with program billing.
Provide back-up assistance for other SHS staff members in order to provide consistent service in times of absences.
Access student and financial information.
Contact with outside insurance companies and providers as necessary to answer questions regarding claim denials, reductions, and other questions. These answers are relayed to the plan holders and clinicians.

5% PUBLIC RELATIONS

Respond to information requests regarding Student Health Service programs, policies, and services.
Answer questions from students, staff, and insurance companies.
Identify and resolve patient billing complaints.
Enlist the help of or routes the public to other Student Health Services departments to answer inquiries as indicated.
Travel and occasional overnight stays may be required to attend seminars necessary to obtain recent updates and changes regarding insurance billing requirements.

5% OTHER tasks AS ASSIGNED

Other tasks as assigned by Support Services Manager

Minimum Qualifications
Two years of technical or professional-level practice advising and/or instructing the public concerning specific programs or processes, monitoring programs, or performing participant reviews.
Additional Required Qualifications
   » expertise of medical billing/business office procedures in a human healthcare environment using electronic medical record (EMR).
   » Proficiency in MS Excel, MS Word;
   » Excellent customer service skills - face to face, telephone, e-mail.
   » capability to execute billing and accounting functions with constant interruptions.
   » This position is designated as a critical or security-sensitive position; therefore, the incumbent must prosperously complete a Criminal History Check and be determined to be position qualified as per OAR 576-055-0000 et seq. Incumbents are required to self-report convictions and those in Youth Programs may have additional Criminal History Checks every 24 months.

Preferred (Special) Qualifications
   » Two years' practice with Insurance/Billing/Patient Accounts; expertise of and practice with claims coding including CPT, Level 1 HCPCs and ICD 10codes.
   » Four years' practice with Insurance/Billing/Patient Accounts; expertise of and practice with claims coding including CPT, Level 1 HCPCs and ICD 10codes; OR a Bachelor's degree in Health Care Administration or related field would substitute for two of the years of required practice.
   » A demonstrable commitment to promoting and enhancing diversity.
   » expertise of inputting insurance information and third party insurance billing.
   » practice that includes entering, compiling, reporting and auditing information/data to ensure regulatory compliance.
   » Progressively responsible practice in an office setting (preferred Medical Office) 4 years.
   » capability to communicate effectively in person and via telephone and in meetings.
   » Highly developed organizational skills; and the capability to multitask easily, quickly, and efficiently.

Working Conditions / Work Schedule Working Schedule for this position is 8 workings hours per day completed: M - F 6:00 am to 6:00 pm. Shift and/or work assignment may be changed located on operational needs.

This is a completely remote position where the person in this function will work independently from a remote location with support supplied by SHS.

This position is deemed essential and the incumbent may be expected to report to work during inclement weather, emergency and other University work curtailments or closures. No
This position requires a clear and unambiguous commitment to compliance of all National Collegiate Athletic Association (NCAA) regulations for Division I (FBS) universities. No

Posting Detail Information

Posting Number P03668CT
Number of Vacancies 1
Anticipated Appointment Begin Date 08/01/2022
Anticipated Appointment End Date
Posting Date 07/05/2022
Full Consideration Date 07/17/2022
Closing Date 08/01/2022
Indicate how you intend to recruit for this search Competitive / External - open to ALL qualified candidates
Special Instructions to candidates To ensure full consideration, applications must be received by July 17th, 2022. Applications will continue to be accepted after the full consideration date, until a sufficient applicant pool has been achieved or the position is filled. The closing date is subject to change without notice to candidates.

Applications will be reviewed located on the information submitted on the employment profile with education and work history along with any other requested documentation i.e. posting specific question responses, transcripts, etc. Your profile MUST clearly show how you meet the minimum/required qualifications for the position. Resumes are NOT accepted at the application stage for classified staff positions.

Typically, the starting income is at the lower end of the income range.

For additional information Contact Us by: Robin Prososki at robin.prososki@oregonstate.edu

OSU is committed to the health of our local and global community. All employees and students are required to comply with the university's COVID-19 Vaccination Program. Please visit https://covid.oregonstate.edu/ for additional information about OSU's plans for safety and success, as well as options for compliance with the vaccination program.

OSU commits to inclusive excellence by advancing equity and diversity in all that we do. We are an Affirmative Action/Equal Opportunity employer, and particularly encourage applications from members of historically underrepresented racial/ethnic groups, women, individuals with disabilities, veterans, LGBTQ community members, and others who demonstrate the capability to help us achieve our vision of a diverse and inclusive community.

This position is designated as a critical or security-sensitive position; therefore, the incumbent must prosperously complete a Criminal History Check and be determined to be position qualified as per OSU Standard 576-055-0000 et seq. Incumbents are required to self-report convictions and those in Youth Programs may have additional Criminal History Checks every 24 months. Offers of employment are contingent upon meeting all minimum qualifications including the Criminal History Check Requirement.

Supplemental Questions

Required fields are indicated with an asterisk (*).
   » * Please describe how your work practice qualifies you for this position.
(Open Ended Question)
   » * Please provide an example email of how you would respond to a student who has charges on their account because their insurance company was out of network.
(Open Ended Question)

Documents Needed to Apply

Required DocumentsOptional Documents

Skills:

Job Category: Other [ View All Other Jobs ]
Language requirements:
Employment type:
Salary: Unspecified
Degree: Unspecified
Experience (year): Unspecified
Job Location: Corvallis, Oregon
Company Type Employer
Post Date: 01/24/2023 / Viewed 275 times
Contact Information
Company: Oregon State University
Contact Email: robin.prososki@oregonstate.edu


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