Financial Counselor, On-Call
2 months ago
Description: This job exists to ensure that all patients' membership status & alternative payer information is accurately identified & documented. Under indirect supervision, provides financial counsel to patients in a personal interview regarding available payer sources and/or health plan coverage. It will accomplish & perform the following important revenue enhancing, member service & organizational compliance functions:Increase revenue through accurate & timely identification of membership status & alternative payers. Enable service representatives to focus on patient service. Verify eligibility for services & counsel patient's on payment alternatives as needed. Follow KP & departmental established guidelines for all lines of business sand MFA Program. Follow established code of conduct for business processes & HIPPA guidelines in compliance w/ all applicable State & Federal regulations. Demonstrate ability to exercise diligence, care & integrity in performance of my duties.Essential Functions:- Confidentially interviews patients who have been referred by service representatives & other internal personnel regarding alternate payer(s) (Non-members, Coordination of Benefits, Third Party Liability, Workers' Compensation) and/or issues regarding eligibility status- Uses independent judgment to identify alternate payer(s) or identify the patient as medically indigent- Requires knowledge of Workers' Compensation, Commercial Insurance Plans, Third Party Liability, & governmental regulations for government programs.- Financial Counselor will investigate potential eligibility for KP membership through available Government Programs (MediCal, MediCare, Transition Plan, etc) & refer for enrollment as appropriate- If the patient is determined to be indigent & has no alternate payer(s), completes a Medical Financial Assistance application & based on an analysis of patient's financial information, recommends approval to Supervisor- May review CPR's, and/or clinical documents to identify potential Third Party Liability and/or Workers' Compensation cases- Obtains pre-authorization from or conducts notification of treatment to employers or other insurance carriers- Eligibility status is verified using on-line eligibility systems- Telephone calls may be placed appropriate departments (Membership Accounting, Sales & Marketing, etc) in cases where group eligibility is not regularly updated- Reviews documentation contained in billable jacket/superbill for completeness- Researches, investigates, & obtains any missing or needed information/documentation prior to being sent to the Business Services Department- KP Service Standards:- Follows established service standards as set forth in LMP ABC's- That is, Take Initiative, Take Responsibility, Take Care & Take Pride- Demonstrate compliance in all above 4 areas- Example: make a positive first impression, protect patient privacy & confidentiality, assume ownership, resolve conflict, show respect, maintain your environment & support your team- Equipment Utilized: Personal Computer, Mainframe CRT, Adding Machine, Fax Machine, Photocopier, Telephone Equipment, Typewriter, Point of Service Device- Assume other activities & responsibilities from time to time as directed Basic Qualifications: 3 to 4 years of relevant experience such as Health Care Billing, Collections or Financial Counseling demonstrates the ability to analyze financial information to determine & negotiate the appropriate financial/billing arrangements Experience in reviewing & analyzing financial information to assess ability to pay Experience in direct member/patient contact Experience w/ automated data bases CRT or PC systems B.S. in business, communications preferred Knowledge of Workers' Compensation, Coordination of Benefits, & Third Party Liability rules & regulations Knowledge of government payer sources such as Medicare, MediCal, etc Knowledge of outside agency sources such as Medicaid, victims of Violent Crime, California Children's Society, Department of Social Services or county agency programs - able to pass standardized test Knowledge of Registration (inpatient/outpatient), health care Billing, Member Service, Membership Accounting or Collection Demonstrated medical terminology & knowledge of ICD9 diagnostic coding &CPT procedural coding is required - able to pass standardized test Ability to use KPDS, OPAS/CARG, ARRS, & FCMS is preferred Ability to interpret insurance requirements & knowledge of health care billing practices Ability to conduct assertive professional & courteous patient financial interviews Must have reliable transportation - will be required to travel by car to medical office buildings as needed to accommodate operational needs or to conduct patient interviews Must provide proof of insurance for vehicle Notes:Financial Counselor Experience required. Position will float to San Marcos, Zion, and San Diego Medical Centers and La Mesa. Primary Location: California,La Mesa,La Mesa Medical Offices Scheduled Weekly Hours: 1 Shift: Variable Workdays: Sun, Mon, Tue, Wed, Thu, Fri, Sat Working Hours Start: 12:01 AM Working Hours End: 11:59 PM Job Schedule: Call-in/On-Call Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: B09OPEIULocal 30 Job Level: Individual Contributor Specialty: Finance Department: La Mesa Admin Bldg. - Admitting - 0801 Pay Range: $28.36 - $33.14 / 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: Yes, 75 % of the Time 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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