Kaiser Permanente Admitting Representative - Grade 5 in Redwood City, California
Under the direct supervision of the Admitting Manager/Supervisor/Designee, the Admitting Representative is a patient service professional responsible for coordinating & completing every phase of the admission function including admissions, preadmissions, interviews for financial & demographic information, obtains & processes advance directives, obtains patient/agent signatures, may initiate valuables collection & distribution, document preparation for all elective, direct &/or emergency admissions, revenue collection in all settings, & data retrieval. Assures confidential treatment of all communications written & verbal. Will initiate & maintain patient room assignments & status until discharge. Acts as a primary informational resource & provides assistance to both internal & external customers. The Admitting Representative must be capable of making decisions & working independently to achieve all departmental functions, as well as maintain an in-depth underst&ing of job duties & changes as admitting decisions have significant financial & medical implications.
Essential Functions: - Instruct & review with patient, information concerning hospitalization - Ascertain health plan status, research eligibility & collect & copy non-KP insurance information - Identifies all uninsured or under-insured patients admitted to facility; refer to Financial Counselors for further action - Obtains verification & necessary pending authorizations from non-KP insurers (including Medicare, Medi-Cal & COB) on members & non-members when Financial Counselor is not available - All documentation is completed in the Member Integrated Tracking System (MITS) or the appropriate KP tracking system - When Financial Counselor is available, discusses the need to obtain authorizations from non-KP insurers - Promote patient satisfaction & retention through the successful facilitation of the revenue collection process - Calculate member liability based on benefit plan - Inform patient/agent & collect appropriate cost share payments for services rendered in all settings (e.g. bedside, follow up phone calls to patient's home, etc.) - Notify patient & when possible collect financial liability for elective procedures & document all interactions - Contact all discharged patients to attempt collection of financial liability & document all interactions - Research payment records of all non-paying patients with liabilities, utilizing system records - Reports findings to Manager/Supervisor/Designee - Analyze revenue data to determine obstacles in cost share collections - Report daily/weekly to Manager/Supervisor/Designee. - Collects all information necessary to bill second-party payers - Interview patients for pre-admission or admission to the hospital, collecting personal, demographic, financial, & medical information in person or by phone per KP policies - Enter complete data into the KP information systems & review for accuracy per department, local, regional, & regulatory compliance - Affix identification bracelet to the patient's wrist on the side of the body opposite the intended procedure or injury per local policy - Underst& & abide by the HIPAA regulations & KP Corporate Compliance - Provide up-to-date information concerning admission & hospital practices & administrative procedures per HIPAA guidelines - Evaluate & attempt to resolve/refer public & patient concerns as they arise - Facilitate the timely admission of patients throughout the hospital by coordinating patient information w/the physicians, Emergency Room, Clinic Departments, House Nursing Supervisor, Patient Care Unit Staff, & outside Care Coordinators per local policy - Receive admission requests - Facilitate appropriate bed assignments & communicates information to staff - Maintain accurate record of cost share status of all patients with liabilities, utilizing revenue tracking system as determined by management - Obtain appropriate signatures on permits & consents per California Hospital Association (CHA) consent guidelines - Prepare related admission paperwork in advance to facilitate a timely admission process - Assemble & coordinate admission materials to create a comprehensive admission package - Distribute relevant brochures/letters to patient/agent (e.g. Medicare letter, Coordination of Benefits (COB) Brochure, advance directive brochure, cost share letter, etc.) - Receive, document, secure & release patient valuables according to St&ard Procedure 18A as appropriate - Initiate membership records on all newborns per local policy - Distribute admission materials to proper locations - Participate in problem-solving as needed to assure organizational revenue targets & customer satisfaction - Escort or arrange for patient escort to assigned room or area per local policy - Answer phones in a professional, courteous & positive manner promoting excellent customer relations when providing information/directions to physicians, staff & public - Maintain high st&ards of excellence & assist Kaiser Permanente fulfill its mission by providing high-quality health care services - Work in a team environment continually enhancing required skills through scheduled training sessions or individually - Attend required meetings, workshops & in-services - Provide support in conducting audits depending upon supervisory need - Perform other related duties as required
Qualifications: Basic Qualifications: - Six (6) months of work experience required. - High school diploma or equivalent - 35 wpm typing or 6000 data entry keystrokes (able to pass either test) - Basic knowledge and use of computer and computer keyboard (able to pass PC skills assessment) - Professional customer service skills - Ability to read, write, understand & follow oral & written instructions - Ability to effectively present information in one-on-one & small group situations to customers & other personnel within the organization - Ability to use basic math - Ability to work rapidly & accurately with phone, personnel & patient interruptions - Ability to multitask, organize & prioritize & work independently with minimal supervision - Proficient in admitting medical terminology (able to pass standardized test) - Must be willing to work in a Labor Management Partnership environment
Preferred Qualifications: - Hospital/clerical setting or medical office preferred - Revenue collection experience preferred - Proficient in word-processing, spreadsheet programs, etc. preferred
Skills Testing: PC Skills Test (able to pass PC skills assessment)
COMPANY Kaiser PermanenteTITLE Admitting Representative - Grade 5LOCATION Redwood City, CAREQNUMBER 608217
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.