Job Summary:
Under direct supervision, provides patient/visitor reception; check in and out; cash handling appointment scheduling; and other Occupational Health Services duties clerical duties as directed. Obtains employer/carrier information for billing/reporting purposes; contacts employers/carriers to obtain authorization for treatment or report status of claims. Reviews records to identify potential billing opportunities and transfer charges to appropriate account, if applicable. Enters pertinent claim information into KP internal computer systems. Orders and photocopies medical records; temporarily covers other desk/functions due to vacation and workload fluctuations; clears designated Health Connect work queues daily, creates patient accounts to register patients and fills in the required KP computerized systems, provides personalized and professional patient/employer/carrier services. Individual must be customer service oriented. Extensive contact with members, non-members, physicians, third party administrators/carriers, and employers/clients. Must be able to provide status of claim; create patient accounts and files; input and maintain information on all appropriate systems as utilized by Kaiser Permanente. Requires excellent interpersonal skills and the ability to multitask in a busy environment.
Essential Responsibilities:
- Answer and screen incoming phone calls for the department. Receives and filters messages to providers/clinicians/case managers/case coordinators through the Health Connect system and replies as appropriate.
- Greet patients/visitors and determine nature of visit. Handle customer inquiries. Assist patients in completing required forms.
- Request for internal/external records. Create accounts in the KP internal systems. Transfer charges to the appropriate KP Health Connect patient account.
- Schedule appointments for workers compensation patients. Interact with internal/external customers to schedule appointments or obtain information.
- Make rounds to certain internal departments to retrieve paperwork, as necessary. Consolidate or correct duplicate accounts by using appropriate system functions.
- Enter account notes on patient cases. Review subpoena requests. Review KP internal systems to ensure that duplicate visits are not captured.
- Complete transfer of care forms. Clear designated Health Connect work queues daily.
- Open and distribute mail to proper areas; match bills to reports and mail to carrier along with any other documentation as necessary.
- Type various documentation as required in our current KP systems. Prepare office supply orders.
- Payment and collection for OHSS services, as required. Perform other related duties as required to maintain efficient departmental operations.
- Promote, ensure and improve customer service to internal/external customers by demonstrating skills which are consistent with the organization's philosophy of providing extraordinary customer relations and quality service as well as all other Kaiser Permanente Policy Procedures.
Basic Qualifications:
Experience
- Typing 35 wpm required.
- All testing must be completed by the end of posting period.
- Minimum of one (1) year relevant clerical and customer service experience in Workers Compensation.
- Successfully passed a medical terminology test.
- Knowledge of Workers Compensation claims processing.
- Cash handling experience.
- Ability to research, summarize and communicate clearly to the public, both verbally and in writing.
- Ability to use a computer to perform assigned duties.
- EQUIPMENT UTILIZED:
- Computer
- Adding Machine
- Fax Machine
- Photocopier
- Telephone
- Typewriter
Education
License, Certification, Registration
Additional Requirements:
- Bilingual (English/Spanish) Level I required.
Preferred Qualifications:
Notes:
- Must successfully pass or have passed the bilingual test (within the last 12 months), or be active in the QBS program.
- Required to work 8:30am-5:30pm if operationally needed.
- 20+ hrs. Required to float to other KPOJ locations & employer work sites. Required to float same day to other KPOJ locations.
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