Outpatient Consultation Representative - Outpatient Scheduling - Full Time - Bilingual (English/Spanish) Preferred

About the role

Kern Medical is seeking a Support Services Associate - Full Time to join our team. This position is responsible for supporting outpatient consult representatives in obtaining prior authorizations and managing patient appointments.

Responsibilities

• Sets up necessary documentation for insurance companies to obtain required prior authorizations for patient care and treatment.
• Tracks and follows up on outstanding requests for authorization.
• Answers patient phone calls, reviews process, and schedules appointments for exam or follow-up.
• Enters all patient demographic information into the electronic patient record system and uses other department applications for eligibility and authorization.
• Screens referrals and informs referring physician offices, patients, and their families about hospital policies and procedures regarding method of payment sources for services rendered.
• Documents funding information from patients and refers them to financial counselors when funding is not in place.
• Utilizes payer resources and websites to explore and assess eligibility.
• Affords assistance with training of staff members.
• Works collaboratively with outpatient scheduling and registration to identify and resolve issues or barriers.
• Submits and responds to requests for information and inquiries related to outpatient authorization/scheduling processes, policies, and other related information; researches and resolves customer problems.

Requirements

• High School Diploma, G.E.D. or equivalent.
• One (1) year of outpatient clinic or medical office experience performing scheduling and/or authorizations, or an equivalent combination of education, training, or experience sufficient to successfully perform the essential duties of the job.

Qualifications

• Knowledge of state and federal government funding programs such as Medicare, Medi-Cal, CCS, TRICARE/CHAMPUS, Workers’ Compensation, and commercial insurance payers.
• Billing and reimbursement guidelines and methodologies for state and federal government and non-government payers.
• Medical and insurance terminology.
• HIPAA privacy and compliance practices.

Skills

• Effective communication both orally and in writing.
• Ability to read, understand, and apply policies and guidelines.
• Ability to establish and maintain effective working relationships with patients, families, and other internal and external customers.
• Ability to work effectively with frequent interruptions and perform multiple tasks in a fast-paced environment.
• Ability to lift, carry, push or pull files and sit at work station for prolonged periods of time.

Benefits

The estimated pay for this position is $23.5229 to $31.6128. The rates shown include a 6% premium pay (base= $-$ plus 6%). This reflects only a portion of the total compensation package for this position. Additional compensation may be available for this role through differentials, incentives, and bonuses. In addition, this position may be eligible for participation and company contributions into the Kern County Employees’ Retirement Plan.