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Patient Access Representative
2 months ago
We are seeking a highly skilled Patient Access Representative to join our team at Kaiser Permanente. As a key member of our healthcare team, you will be responsible for performing general patient access and registration duties in EPIC Practice Management. This includes answering telephones, making appointments, processing referrals, maintaining provider templates and appointment schedules, verifying patient demographics and insurance coverage, and performing general patient account management duties.
Key Responsibilities- Patient Access and Registration: Answer phones, perform appointment making processes, complete accurate patient registration, verify patient demographics and payor coverage, perform check-in, check-out, admit and discharge tasks, build and maintain appointing templates, perform MyGH set up verification, communicate with patients via multiple channels, and 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, and 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, and prepare bank documentation, combine and reconcile deposits of cashiers in the facility.
- Customer Service: Adhere to Kaiser Permanente behavior and appearance standards, demonstrate strong customer service and communication skills, treat customers with courtesy and respect, adhere to HIPAA and patient confidentiality requirements, and may act as a guide when a patient accesses Kaiser Permanente services.
- Minimum one year of experience in a business office within a medical care delivery, hospital, insurance or large contact center environment or a minimum two years of experience providing excellent customer service in a fast-paced environment.
- High School Diploma or General Education Development (GED) required.
- Basic PC skills in MS Windows environment, 10-key and typing (35 WPM) required.
- Customer service skills, the ability to effectively communicate with a diverse customer base, and strong organizational skills required.
- Three years of additional experience in a patient care setting.
- Use of Epic Cadence/Prelude/Resolute or other patient scheduling and accounting systems.
- Understanding of Kaiser Permanente billing protocols and cash posting systems.
- 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.
- Six months experience in processing various types of billing, including workers compensation, subrogation, coordination of benefits, and private/self-pay.
- 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.
- Vocational training in medical office procedures and billing.
- Coursework or practical training and experience in ICD-9 and CPT coding.
We are 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.
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.
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.
