Patient Access Representative Job at Kaiser Permanente (Seattle)

Job Description

A critical part of total care. You’ll work directly with our members around the country to help meet their needs and also help them understand our offerings, policies, and procedures.

Job Responsibility

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
Patient Access and Registration: Answer phones
Perform appointment making processes
Complete accurate patient registration, such as verification of 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

Requirements

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 of two (2) years of experience providing excellent customer service in a fast-paced environment
High School Diploma OR General Education Development (GED) required
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

Nice to have

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

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