Patient Access Representative (Evening Shift)

Perform general patient access and registration duties in EPIC Practice Management, including answering telephones, scheduling appointments, processing referrals, maintaining provider templates and appointment schedules, verifying patient demographics and insurance coverage. Manage patient accounts by obtaining prior authorizations, processing work queue items, ensuring compliance with Kaiser Permanente standards and payor billing requirements, and acting as a liaison to Patient Financial Services and the Health Plan. Communicate with external government payors and employers as needed, assist patients with billing inquiries, and provide fee estimates for services. May handle cash collection and depositing duties.

Responsibilities

• Patient Access and Registration:
  • Answer phones and perform appointment scheduling
  • Complete accurate patient registration, including verification of 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 items in 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 for professional services
  • Provide fee estimates for Kaiser Permanente 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 and reconcile deposits
• 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
  • May act as the first point of contact for patients accessing 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 two (2) years of experience providing excellent customer service in a fast-paced environment (waived for current KP Coalition employees per the National Agreement)
• 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 and the ability to effectively communicate with a diverse customer base
• Strong organizational skills

Preferred Qualifications

• 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
• Familiarity 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
• Demonstrated adaptability, productivity, and reliability, with the ability to work independently in an ambiguous environment
• Effective interpersonal, communication, and customer service skills for face-to-face and telephone interactions
• 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
• Vocational training in medical office procedures and billing
• Coursework or practical training and experience in ICD-9 and CPT coding

Schedule

• Scheduled Weekly Hours: 40
• Shift: Evening
• Workdays: Mon, Tue, Wed, Thu, Fri
• Working Hours Start: 01:15 PM
• Working Hours End: 09:45 PM
• Job Schedule: Full-time
• Worker Location: Onsite

Pay

$23.73 - $35.91 / hour. Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.