Patient Access Representative
4 days ago
As a Patient Access Representative at Kaiser Permanente, you will play a vital role in ensuring seamless patient access and registration processes. Your primary responsibilities will include answering telephones, making appointments, verifying patient demographics and insurance coverage, and maintaining provider templates and appointment schedules. You will also be responsible for processing referrals, obtaining prior authorization for services, and ensuring patient accounts and coverage structures meet Kaiser Permanente standards and billing requirements. Additionally, you will serve as a liaison to Patient Financial Services and the Health Plan, communicating with external government payors and employers as necessary. Your strong customer service and communication skills will be essential in providing excellent patient care and ensuring a positive experience for our patients.
Essential 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, 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.
Experience
- Minimum one (1) year of experience in a business office within a medical care delivery, hospital, insurance or large contact center environment OR a 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.
- High School Diploma OR General Education Development (GED) required.
- N/A
- Experience in electronic patient accounting, scheduling or customer information systems.
- Basic PC skills in MS Windows environment, 10-key and typing (35 WPM).
- Customer service skills, the ability to effectively communicate with a diverse customer base, and strong organizational skills.
- Three (3) 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 (6) 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.
Scheduled Weekly Hours: 40
Shift: Evening
Workdays: Mon, Tue, Wed, Thu, Fri
Working Hours Start: 10:00 AM
Working Hours End: 07:00 PM
Job Schedule: Full-time
Job Type: Standard
Worker Location: Onsite
Employee Status: Regular
Employee Group/Union Affiliation: J04|OPEIU|OPEIU Local 8
Job Level: Individual Contributor
Department: Central Campus South - Reception/Cashier
Pay Range: $26.4 / 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
On-site: Work location is on-site (KP designated office, medical office building or hospital). Worker location must align with Kaiser Permanente's Authorized States policy. 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
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