SEIU Local 105 - $21.00 - $28.56 “May be entitled to translation/bilingual, shift or other wage premiums as governed by the applicable collective bargaining agreement. Please refer to the respective collective bargaining agreement for additional information on such wage premiums: https://www.lmpartnership.org/local-contracts. Job Summary:Performs prospective review, ordering, analysis, and reporting of Kaiser Permanente (KP) medical transports for members in the region. Interacts with staff and physicians to answer inquiries.Educates on covered benefits for members. Interacts with staff and members in pre-service denials processing. Records patient demographic and medical information and reports the information to designated medical transportation dispatching. Actively seeks information to understand member/patient circumstances, problems, expectations, and needs. Considers how actions or plans will affect members; responds quickly to meet member/patient needs and resolves problems.Essential Responsibilities:
This position, knows and complies with all KP quality, safety, and emergency policies and procedures. Demonstrates quality and effectiveness in work habits and clinical practice in every interaction with patients, colleagues, providers, and leadership. Ensures patient safety in the preparation and provisioning of care related to but not limited to medications, procedures, infection prevention, fall prevention, including consistent use of two patient identifiers and procedural time outs. Reports safety hazards, accidents and incidents, and unsafe working conditions promptly.
Provide excellent customer service to internal and external providers and members.
Answers phones and routes calls appropriately.
Inputs health plan membership and confirm benefits appropriately.
Inputs all relevant data into computer database and coordinates patient transfers effectively and completely.
Documents patient information in KP HealthConnect and other KP systems accurately
Review, process, and coordinate all benefit covered clinical transportation requests and authorizations in a timely manner.
Assists with problem-solving issues that arise between KP and AMR/Pathways regarding transport.
Provide physicians, nurses, ambulance vendors and all other inquiries with accurate information regarding Kaiser Permanente Colorado (KPCO) regional transportation policies and procedures.
Remain current and up to date on Medicare guidelines pertaining to coverage of medical transportation.
Multi-task in a fast-paced call environment.
Functions as a member of the Telephonic Medicine Center (TMC) team to assist in a variety of functions.
Collaborate with other members of the TMC and KP resources to problem solve issues related to transportation.
Attend mandatory department meetings and perform miscellaneous duties as assigned by supervisor/manager.
Position requires working over the phone with interruptions.
May be required to lift, bend, and sit for prolonged periods of time.
Perform other duties as assigned.
Meet or exceed productivity expectations (ex. phone service levels, average speed of answer, average handle times, number of calls) to be reviewed and refined within 3 months after start of position.
Basic Qualifications:
Experience
Minimum three (3) years of experience in health care or health insurance required.
Minimum of one (1) year of combined experience with word processing, data entry/tracking database computer applications.
Education
High School Diploma or General Education Development (GED) required.
License, Certification, Registration
N/A
Additional Requirements:
Testing Required: typing speed of 45wpm required, data entry accuracy.
Working knowledge of medical terminology.
Ability to work perform in an independent nature such as: experience with very limited on-site supervision, or experience with significant self-directed accountabilities.
Due to the independent nature of this position, the incumbent must be punctual and have an excellent attendance record.
Ability to effectively coordinate multiple tasks.
Ability to prioritize and reprioritize daily tasks continuously throughout the shift.
Demonstrated ability to effectively communicate and negotiate resolution of problems. Strong customer service skills required to communicate effectively with providers, outside vendors and levels of management.
Must be able to work in a labor/management partnership environment.
Preferred Qualifications:
EMS or hospital dispatch experience.
Knowledge of Kaiser Permanente Health Plan (KPHP) coverage benefits, state, federal and local regulatory agency requirements.
Prior knowledge of type of ambulance service (i.e., BLS, ALS, CCT) and benefit summary.
Working knowledge of Health Connect (Epic)
COMPANY: KAISERTITLE: Medical Transportation Center ClerkLOCATION: Aurora, ColoradoREQNUMBER: 1293354External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
