Patient Access Representative

Patient Access Representative

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.

Essential Responsibilities:

• 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.

Basic Qualifications: 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.

Education

• High School Diploma OR General Education Development (GED) required.

License, Certification, Registration

• N/A

Additional Requirements:

• 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.