Job Summary:Perform general patient access and registration duties in EPIC Practice Management, such as, answer telephones, make appointments, process referrals, maintain provider templates and appointment schedules, verify patient demographics and insurance coverage. Perform general patient account management duties, such as, obtain prior authorization for services, process items in the appropriate work queues to complete registration and enter service capture data. Ensure patient accounts and coverage structures meet Kaiser Permanente standards and billing requirements of various payors. Function as liaison to Patient Financial Services and the Health Plan. Communicate with external government payors and employers, as necessary. Work directly with patients on billing related matters and provide fee estimates to patients for Kaiser Permanente services. May perform duties related to cash collection and depositing. Demonstrate strong customer service and communication skills. Adhere to HIPAA and patient confidentiality requirements. May act as the patients first point of contact with Kaiser PermanenteEssential Responsibilities:
Patient Access and Registration
Answer phones
Perform appointment making processes
Complete accurate patient registration, such as, verification of patient demographics and payor coverage
Perform check-in, check-out, admit and discharge tasks
Build and maintain appointing templates
Perform online account set up verification
Communicate with patients via multiple channels
Process internal and external referrals
General Account Management
Confirm and set up payor coverage structures
Obtain prior authorization for services
Process appropriate items in the patient, claim edit and charge review work queues
Act as liaison to Patient Financial Services and the Health Plan
Communicate with external government payors and employers, as necessary
Perform manual service capture and data entry
Act as liaison to Health Information Management Coding Specialist for facility specific coding issues
Apply account review criteria and billing guidelines in preparation for off site billing of professional services
Provide fee estimates for KP services
Assist patients with billing questions
Cash Collection and Depositing
Collect co-pays and cost shares for services
Process refunds
Perform daily cash reconciliation and reporting for retail transactions
Process daily till closeout
Prepare bank documentation, combine and reconcile deposits of cashiers in the facility
Customer Service
Adhere to Kaiser Permanente behavior & appearance standards
Demonstrate strong customer service and communication skills
Treat customers with courtesy and respect
Adhere to HIPAA and patient confidentiality requirements
May act as a guide when a patient accesses Kaiser Permanente services
Basic Qualifications:
Experience
Minimum one (1) year of experience in a business office of a medical care delivery, hospital, insurance company or a large contact center AND experience in electronic patient accounting, scheduling or customer information systems OR minimum two (2) years of experience providing excellent customer service in a fast-paced environment.
Per the National Agreement, current KP Coalition employees have this experience requirement waived.
Education
High School Diploma OR General Education Development (GED) required.
License, Certification, Registration
N/A
Additional Requirements:
Basic PC skills in MS Windows environment.
10-key and typing (35 WPM).
Customer service skills.
Ability to effectively communicate with a diverse customer base.
Srong organizational skills.
Preferred Qualifications:
One (1) year of experience in processing various types of billing, including workers compensation, subrogation, coordination of benefits, and private/self-pay.
Three (3) years of additional experience in a patient care setting.
Familiar with medical terminology.
Knowledge of delivery system business operations processes, including appointing, account intake and verification, cashiering, financial interviewing, referral processing and data entry.
Working knowledge of health care insurance practices and billing.
Knowledge of health care payer/insurer types, including state and federal workers compensation, commercial, subrogation, self-insured, Medicare (CMS) and Medicaid (DSHS).
Understanding of Kaiser Permanente insurance products and benefits.
Proven ability to establish credibility and respect with patients.
Proven ability to problem solve and take initiative.
Ability to provide feedback and education to other staff regarding correct procedures.
Demonstrate a high degree of adaptability, productivity, and reliability as well as an ability to work independently in an ambiguous environment.
Effective interpersonal, communication, and customer service skills for both face-to-face and telephone interactions with patients, medical staff, and team members.
Positive, open-minded, and focused on continuous improvement.
Ability to learn new processes, procedures, and software programs quickly, while demonstrating attention to detail and accuracy in their daily work.
Use of Epic Cadence/Prelude/Resolute or other patient scheduling and accounting systems.
Understanding of Kaiser Permanente billing protocols and cash posting systems.
Vocational training in medical office procedures and billing.
Coursework or practical training and experience in ICD-9 and CPT coding.
COMPANY: KAISERTITLE: Patient Access Representative - MUST live in Washington or relocateLOCATION: Seattle, WashingtonREQNUMBER: 1323445External 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.
