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OHS Claims Processor I

1 month ago

Bakersfield, United States Kaiser Permanente Full time

Description: Under direct supervision, provides patient/visitor reception; check in and out; cash handling appointment scheduling; and otherOccupational Health Service's duties clerical duties as directed. Obtains employer/carrier information for billing/reporting purposes;contact employers/carriers to obtain authorization for treatment or report status of claims. Review of records to identify potential billing opportunities and transfer charges to appropriate account, if applicable. Enter pertinent claim information into KP internalcomputer systems. Ordering and photocopying medical records; temporarily cover other desk/functions due to vacation andworkload fluctuations; clears designated Health Connect work queues daily, creates patient accounts to register patients and fills inthe required KP computerized systems; provides personalized and professional patient/employer/carrier services. Individual mustbe customer service oriented. Extensive contact with members, non-members, physicians, third party administrators/carriers andemployers/clients. Must be able to provide status of claim; create patient accounts and files; Input and maintain information on allappropriate systems as utilized by Kaiser Permanente. Requires excellent interpersonal skills and the ability to multitask in a busyenvironment.Essential Responsibilities:Answer and screen incoming phone calls for the department. Receives and filters messages toproviders/clinicians/case managers/case coordinators through the Health Connect system and reply as appropriate.Greet patients/visitors and determine nature of visit. Handles customer inquires. Assists patients in completingrequired forms.Request for internal /external records. Creates accounts in the KP internal systems. Transfer chargesto the appropriate KP Health Connect patient account.Schedule appointments for workers' compensation teract with internal/external customers to schedule appointments or obtain information.Make rounds to certaininternal departments to retrieve paperwork, as necessary.Consolidate or corrects duplicate accounts by usingappropriate system functions.Enters account notes on patient cases.Reviews subpoena requests.Review KPinternal systems to ensure that duplicate visits are not plete transfer of care forms.Clear designated Health Connect work queues daily.Open and distribute mail to proper areas; match bills to reports and mail to carrieralong with any other documentation as necessary.Type various documentation as required in our current KP systems.Prepare office supply orders.Payment and collection for OHSS services, as required.Performs other related dutiesas required to maintain efficient departmental operations.Promotes, ensures and improves customer service tointernal/external customers by demonstrating skills which are consistent with the organization's philosophy of providingextraordinary customer relations and quality service as well as all other Kaiser Permanente Policy Procedures. Basic Qualifications:Experience Minimum one (1) year of relevant clerical and customer service experience in Workers' Compensation.Education High school diploma/GED.License, Certification, Registration N/A Additional Requirements: Cash handling experience. Successfully passed a medical terminology test. Typing 35 wpm required. Knowledge of Workers' Compensation claims Processing. Ability to research, summarize and communicate clearly to the public,both verbally and in writing. Ability to use computer to perform assigned duties. Equipment Utilized: Computer, Adding Machine, Fax Machine, Photocopier, Telephone and Typewriter. Bilingual (English/Spanish) Level I required. Preferred Qualifications: N/ANotes:Must successfully pass or have passed the bilingual test (within the last 12 months), or be active in the QBS program. Primary Location: California,Bakersfield,Stockdale Medical Offices Scheduled Weekly Hours: 30 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri, Working Hours Start: 10:00 AM Working Hours End: 05:00 PM Job Schedule: Part-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: B20UFCWLocal 770 Job Level: Individual Contributor Department: Stockdale MOB - Occupational Health-Reg Clin - 0806 Pay Range: $26.46 - $30.11 / hour The ranges posted above reflect the location in the job posting. The salary range may vary if you reside in a different location or state than the location posted. Travel: No At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing. Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status. Submit Interest Load More

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