Description: 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 Permanente
Essential Responsibilities:
Patient Access and RegistrationAnswer phonesPerform appointment making processesComplete accurate patient registration, such as, verification of patient demographics and payor coveragePerform check-in, check-out, admit and discharge tasksBuild and maintain appointing templatesPerform online account set up verificationCommunicate with patients via multiple channelsProcess internal and external referralsGeneral Account ManagementConfirm and set up payor coverage structuresObtain prior authorization for servicesProcess appropriate items in the patient, claim edit and charge review work queuesAct as liaison to Patient Financial Services and the Health PlanCommunicate with external government payors and employers, as necessaryPerform manual service capture and data entryAct as liaison to Health Information Management Coding Specialist for facility specific coding issuesApply account review criteria and billing guidelines in preparation for off site billing of professional servicesProvide fee estimates for KP servicesAssist patients with billing questionsCash Collection and DepositingCollect co-pays and cost shares for servicesProcess refundsPerform daily cash reconciliation and reporting for retail transactionsProcess daily till closeoutPrepare bank documentation, combine and reconcile deposits of cashiers in the facilityCustomer ServiceAdhere to Kaiser Permanente behavior & appearance standardsDemonstrate strong customer service and communication skillsTreat customers with courtesy and respectAdhere to HIPAA and patient confidentiality requirementsMay 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.